Myopathy in Cushing's Syndrome

Müller, Ragnar; Kugelberg, Eric

doi:10.1136/jnnp.22.4.314

Cited by 101 publications

(21 citation statements)

References 6 publications

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“…The development of muscle weakness and atrophy is a well-known complication of therapy with exogenous glucocorticoids and Cushing's dis ease [17,18], and it has been ascribed primarily to the inhibition of protein synthesis [19,20], There is, however, also an increase in muscle protein breakdown, as suggested by the observed increase in urinary creatinine excretion and the concomitant rise in plasma creatinine concentration in the present study. These findings leave no other explana tion, for creatinine output in the urine is assumed to be proportional to muscle mass [21], The assumption is valid on condition that the diet is fairly constant, as was the case in our study.…”

Section: Discussionmentioning

confidence: 39%

Effect of Prednisone on Renal Function in Man

Acker

Prummel²,

Weber³

et al. 1993

Nephron

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To clarify the rise in plasma creatinine concentration previously observed during prednisone treatment, we studied changes in renal function in Graves’ ophthalmopathy patients before and after 2 weeks of either prednisone 60 mg/day or retrobulbar radiotherapy (controls). Compared to retrobulbar radiotherapy, prednisone treatment was associated with an increase in: (a) plasma creatinine concentration (from 68 ± 4 to 76 ± 4 μmol/l), (b) glomerular filtration rate (GFR, from 93 ± 4 to 102 ± 5 ml/min/1.73 m²), and (c) urinary creatinine excretion rate (from 510 ± 40 to 570 ± 40 μmol/h). We conclude that GFR rises during 2 weeks of high-dose prednisone administration, a rise that is not reflected by a decrease in plasma creatinine concentration. On the contrary, both plasma creatinine concentration and urinary creatinine excretion increase, probably as a result of the catabolic effect of prednisone. As established by the present study, prednisone 60 mg/day is associated with protein wasting, also after 14 days of treatment.

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Section: Discussionmentioning

confidence: 39%

Effect of Prednisone on Renal Function in Man

Acker

Prummel²,

Weber³

et al. 1993

Nephron

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“…the plantaris) were studied. It is of interest that muscular wasting in Cushing's syndrome (Forsham, 1968) in human beings is most marked in the thigh musculature (Muller & Kugelberg, 1959;Perkhoff, Silber, Tyler, Cartwright & Wintrobe, 1959). Possibly this specificity is related to a preponderance ofphasic muscles in this area, although information on the distribution of red or pale muscle fibres in man is presently not available.…”

Section: Resultsmentioning

confidence: 99%

Relationship between cortisone and muscle work in determining muscle size

Goldberg¹,

Goodman²

1969

The Journal of Physiology

168

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SUMMARY1. Large doses of cortisone caus3d marked atrophy of the plantaris muscle and other pale muscles of hind limbs of hypophysectomized rats, but hormone treatment had little effect on the size of the red soleus muscle.2. Denervation increased the sensitivity of the soleus and plantaris to the catabolic effects of cortisone.3. Increased work induced by tenotomy of the synergistic gastrocnemius made the plantaris muscle less sensitive to cortisone-induced atrophy.4. Since the catabolic effects of cortisone are more pronounced in the less active muscles, it is suggested that in mobilizing body protein for gluconeogenesis the hormone spares those muscles physiologically most active. 5. The rapidity with which muscles lose weight in response to cortisone indicates that the hormone must decrease protein half-lives as well as decrease protein synthesis.

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“…The development of muscle weakness and atrophy is a well known complication of therapy with exogenous glucocorticoids and Cushing's disease (1,2). It is probably the most common form of drug-induced myopathy encountered in clinical practice (3).…”

Section: Introductionmentioning

confidence: 99%

Impact of physical training on the ultrastructure of midthigh muscle in normal subjects and in patients treated with glucocorticoids.

Horber¹,

Hoopeler²,

Scheidegger³

et al. 1987

J. Clin. Invest.

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Exercise-training might be a logical method to reverse muscle atrophy and weakness in patients treated with glucocorticoids. The purpose of the present investigation was to establish whether a treatment with low dose prednisone (10±2.9 mg/d) modulates the effect of a moderate strength type isokinetic training during 7 wk (21 sessions of 20 min) on "muscle efficiency" (power output/muscle mass) and on concomitant changes in ultrastructure of the thigh muscle measured by quantitative electron-microscopic morphometry. Training caused a similar increase in "muscle efficiency" in patients on prednisone (a = 9) as in normal volunteers (a = 9). In normal subjects the increase in muscle efficiency was associated with an increase in sarcoplasm, whereas in patients on prednisone the functional improvement was associated with an increase in sarcoplasm, capillaries, and mitochondria content. Thus, a therapy with low dose prednisone does not abrogate training-induced improvement of muscle efficiency but modulates the ultrastructural response of the muscle to the trinng.

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Myopathy in Cushing's Syndrome

Cited by 101 publications

References 6 publications

Effect of Prednisone on Renal Function in Man

Effect of Prednisone on Renal Function in Man

Relationship between cortisone and muscle work in determining muscle size

Impact of physical training on the ultrastructure of midthigh muscle in normal subjects and in patients treated with glucocorticoids.

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