Acute quadriplegic myopathy with loss of thick (myosin) filaments following heart transplantation

Perea, Milagrosa; Picón, M.; Miró, Òscar; Orús, Josefina; Roig, Eulàlia; Grau, Josep M.

doi:10.1016/s1053-2498(01)00300-x

Cited by 34 publications

(10 citation statements)

References 22 publications

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“…[3][4][5] While Bolton and colleagues were studying CIP, there were also reports of single cases [10][11][12][13][14] and eventually series [15][16][17][18][19][20][21] of adult and pediatric 10 patients who developed acute myopathy during treatment of status asthmaticus. Later, a similar acute myopathy was noted to follow organ transplantation [22][23][24][25][26][27] and to occur in association with many other critical illness states in children as well as adults. [28][29][30][31][32][33][34][35] Terminology was highly variable initially, but eventually the name critical illness myopathy (CIM) was accepted.…”

Section: Historymentioning

confidence: 99%

Neuromuscular Disorders in Critically Ill Patients: Review and Update

Lacomis

2011

Journal of Clinical Neuromuscular Disease

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Neuromuscular disorders that are diagnosed in the intensive care unit (ICU) usually cause substantial limb weakness and contribute to ventilatory dysfunction. Although some lead to ICU admission, ICU-acquired disorders, mainly critical illness myopathy (CIM) and critical illness polyneuropathy (CIP), are more frequent and are associated with considerable morbidity. Approximately 25% to 45% of patients admitted to the ICU develop CIM, CIP, or both. Their clinical features often overlap; therefore, nerve conduction studies and electromyography are particularly helpful diagnostically, and more sophisticated electrodiagnostic studies and histopathologic evaluation are required in some circumstances. A number of prospective studies have identified risk factors for CIP and CIM, but their limitations often include the inability to separate CIM from CIP. Animal models reveal evidence of a channelopathy in both CIM and CIP, and human studies also identified axonal degeneration in CIP and myosin loss in CIM. Outcomes are variable. They tend to be better with CIM, and some patients have longstanding disabilities. Future studies of well-characterized patients with CIP and CIM should refine our understanding of risk factors, outcomes, and pathogenic mechanisms, leading to better interventions.

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Section: Historymentioning

confidence: 99%

Neuromuscular Disorders in Critically Ill Patients: Review and Update

Lacomis

2011

Journal of Clinical Neuromuscular Disease

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“…21,22 CIM also has been reported in patients after heart transplantation. 23 Common to all three of these populations is critical illness and associated systemic inflammation with increased cytokine expression as well as the likelihood that their treatment course would have included either NMBDs, corticosteroids, or both. The medical literature has, for more than 20 years, described the development of weakness following use of NMBDs to facilitate mechanical ventilation or for other reasons (i.e., to prevent rises in intrathoracic or intracranial pressures).…”

Section: Risk Factorsmentioning

confidence: 99%

Is There a Polymyopathy or Polyneuropathy of Critical Illness? What Is It and How Is It Diagnosed and Managed? How Does It Affect Outcome?

Kucik¹,

Bittner²,

Martyn³

2010

Evidence-Based Practice of Critical Care

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“…YBÜ' de yatan hastalarda gelişen yaygın kuvvet kaybı nedenlerinden biri olan KHM'nin gerçek sıklığı bilinmese de 4, status astmatikus tedavisi için yatan hastaların üçte birinde, karaciğer transplantasyonundan sonra %7 hastada ve kalp transplantasyonundan sonra bir grup hastada görüldüğü bildirilmiştir [40][41][42] . Kısaca, kritik hastalık başlangıcını takiben gelişen kuvvet kaybı olarak belirtilebilecek KHM için önerilen tanı kriterleri Tablo 2'de sunulmuştur.…”

Section: Kri̇ti̇k Hastalik Mi̇yopati̇si̇unclassified

13 Critical Illness Polyneuropathy and Myopathy

2009

Decision Making in Neurocritical Care

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ÖZETBilimsel zemin: Kritik hastalığın nöromusküler belirtileri olan polinöropati ve/veya miyopati, yoğun bakım ünitelerinde bir haftadan daha uzun süre yatan hastalarda gelişir. Sıklıkla altta yatan neden sepsis ve/veya çoklu organ yetmezliği veya steroid-nöromusküler kavşak bloke edici ilaç kullanımıdır. Özellikle ekstremite ve solunum kaslarında kuvvet kaybı ve uzamış mekanik ventilasyon ihtiyacına neden olurlar. Polinöropati akut ve aksonal tarzdadır, miyopati ise dört farklı tipte kendini gösterebilir. Genellikle bu hastalıklar gelişmeden önce görülen ensefalopati tablosu hastaların geç tanı almalarına sebebiyet vermektedir. İyi klinik izlem, erken evrede yapılacak elektrofizyolojik ve laboratuar çalışmalar, gerekli durumlarda alınacak biyopsi doğru tanıyı kolaylaştırır. Sıklıkla bir arada görülen bu hastalıkların erken evrede doğru tanı almaları ve ayırıcı tanılarının ayrıntılı yapılması önemlidir, çünkü bu sayede doğru tedavi uygulanabilir, ayrıca sağkalım üzerine doğrudan etkili olan bu hastalıklar ile mücadele edilebilinir. Çıkarımlar: Günümüzde daha iyi tanımlanmaya başlanan risk faktörlerinin elimine edilmesi bu hastalıkların görülebilirliklerini azaltabilir. Henüz özgül bir tedavi olmasa da, destekleyici tedaviler, sepsis ile agresif savaşım, hastalığa neden olabilecek medikal tedavilerin uzaklaştırılması hastaya yarar sağlayabilir. Anahtar Kelimeler: Kritik hastalık, polinöropati, miyopati CRITICAL ILLNESS POLYNEUROPATHY AND MYOPATHY ABSTRACTBackground: Critical illness polyneuropathy (CIP) and clinical illness myopathy (CIM) frequently develop in patients hospitalized in the intensive care unit for more than 1 week. The underlying disorders are usually sepsis and/or multiorgan failure or treatment with neuromuscular blocking agents and steroids. CIP and CIM present with muscle weakness, especially in extremities and respiratory muscles, and failure to wean from mechanical ventilation. While polyneuropathy is an acute axonal one, myopathy has four main types. Encephalopathy which generally occurs before CIP and/or CIM may lead to a delay in diagnosis. Close follow-up of neurological functions, performing electrophysiological and laboratory studies in early period and taking biopsies as indicated leads to correct diagnosis. Early diagnosis and a systematic differential diagnosis of CIP and CIM which are usually seen simultaneously and directly related to survival are important, so that they can be managed properly. Conclusion: The incidence of CIP and CIM may be reduced by eliminating the currently defined risk factors. Although specific therapies have not been discovered, supportive treatment, aggressive management of sepsis and elimination of contributory medications may be beneficial.

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Acute quadriplegic myopathy with loss of thick (myosin) filaments following heart transplantation

Cited by 34 publications

References 22 publications

Neuromuscular Disorders in Critically Ill Patients: Review and Update

Neuromuscular Disorders in Critically Ill Patients: Review and Update

Is There a Polymyopathy or Polyneuropathy of Critical Illness? What Is It and How Is It Diagnosed and Managed? How Does It Affect Outcome?

13 Critical Illness Polyneuropathy and Myopathy

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