Steroid myopathy in connective tissue disease

Askari, Alireza; Vignos, Paul J.; Moskowitz, Roland W.

doi:10.1016/0002-9343(76)90327-2

Cited by 244 publications

(78 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Elevated urinary Cr:Cn ratios have been reported in adults with DM and PM (19,23). Although it has been suggested that elevated Cr:Cn ratios reflect a steroid-induced myopathy (23), we have previously found no evidence to support this suggestion in adults (19).…”

Section: Discussioncontrasting

confidence: 69%

See 1 more Smart Citation

Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

et al. 2005

View full text Add to dashboard Cite

Objective. To assess for novel markers of muscle damage using urinary muscle metabolites by 1 H magnetic resonance spectroscopy in patients with juvenile idiopathic inflammatory myopathy (IIM). Methods. Creatine (Cr), choline (Cho), betaine (Bet), glycine (Gly), trimethylamine oxide (TMAO), and several other metabolites were measured in first morning void urine samples from 45 patients with juvenile IIM and from 35 healthy age-matched controls, and correlated with measures of myositis disease activity and damage. Urinary metabolite to age-adjusted creatinine (Cn) ratios were examined. Results. Age-adjusted initial

show abstract

Section: Discussioncontrasting

confidence: 69%

“…In adults elevated Cr:Cn ratios are not specific for inflammatory myopathies (23), which is also the case in children with juvenile IIM (an increased level of urinary Cr was also observed in normal …”

Section: Discussionmentioning

confidence: 94%

Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

et al. 2005

View full text Add to dashboard Cite

show abstract

“…However, one of the main side-effects of systemically administered corticosteroids is skeletal muscle myopathy, involving respiratory as well as peripheral muscles. The incidence of steroid-induced myopathy varies from 7% [1] to 60% [2] in patients receiving glucocorticoid treatment for various diseases. Glucocorticoids have been shown to cause mainly atrophy of fast-twitch type II muscle fibers with less or no impact on type I fibers [3].…”

Section: Introductionmentioning

confidence: 99%

Corticosteroid effects on ventilator-induced diaphragm dysfunction in anesthetized rats depend on the dose administered

et al. 2010

View full text Add to dashboard Cite

BackgroundHigh dose of corticosteroids has been previously shown to protect against controlled mechanical ventilation (CMV)-induced diaphragmatic dysfunction while inhibiting calpain activation. Because literature suggests that the calpain inhibiting effect of corticosteroid depends on the dose administered, we determined whether lower doses of corticosteroids would also provide protection of the diaphragm during CMV. This may be important for patients undergoing mechanical ventilation and receiving corticosteroids.MethodsRats were assigned to controls or to 24 hours of CMV while being treated at the start of mechanical ventilation with a single intramuscular administration of either saline, or 5 mg/kg (low MP) or 30 mg/kg (high MP) of methylprednisolone.ResultsDiaphragmatic force was decreased after CMV and this was exacerbated in the low MP group while high MP rescued this diaphragmatic dysfunction. Atrophy was more severe in the low MP group than after CMV while no atrophy was observed in the high MP group. A significant and similar increase in calpain activity was observed in both the low MP and CMV groups whereas the high dose prevented calpain activation. Expression of calpastatin, the endogenous inhibitor of calpain, was decreased in the CMV and low MP groups but its level was preserved to controls in the high MP group. Caspase-3 activity increased in all CMV groups but to a lesser extent in the low and high MP groups. The 20S proteasome activity was increased in CMV only.ConclusionsAdministration of 30 mg/kg methylprednisolone during CMV protected against CMV-induced diaphragm dysfunction while 5 mg/kg was more deleterious. The protective effect is due mainly to an inhibition of the calpain system through preservation of calpastatin levels and to a lesser extent to a caspase-3 inhibition.

show abstract

“…Myopathy and atrophy of peripheral skeletal muscles are wellknown side effects oftreatment with corticosteroids, especially with fluorinated steroids (1)(2)(3)(4)(5). Recent animal studies have demonstrated that the diaphragm may be involved (6)(7)(8)(9)(10)(11)(12), but the extent to which the human diaphragm may be affected is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

Dekhuijzen¹,

Gayan‐Ramirez²,

Bock³

et al. 1993

J. Clin. Invest.

View full text Add to dashboard Cite

Diaphragm atrophy and weakness occur after administration of massive doses of corticosteroids for short periods. In the present study the effects of prolonged administration of moderate doses of fluorinated and nonfluorinated steroids were investigated on contractile properties and histopathology of rat diaphragm. 60 rats received saline, 1.0 mg/kg triamcinolone, or 1.25 or 5 mg/kg i.m. prednisolone daily for 4 wk. Respiratory and peripheral muscle mass increased similarly in control and both prednisolone groups, whereas triamcinolone caused severe muscle wasting. Maximal tetanic tension averaged 2.23±0.54 kg/cm2 (SD) in the control group. An increased number of diaphragmatic bundles in the 5-mg/kg prednisolone group generated maximal tetanic tensions < 2.0 kg/cm2 (P < 0.05). In addition, fatigability during the force-frequency protocol was most pronounced in this group (P < 0.05). In contrast, triamcinolone caused a prolonged half-relaxation time and a leftward shift of the force-frequency curve (P < 0.05). Histological examination of the diaphragm showed a normal pattern in the control and 1.25-mg/kg prednisolone group. Myogenic changes, however, were found in the 5-mg/kg prednisolone group and, more pronounced, in the triamcinolone group. Selective type Ilb fiber atrophy was found in the latter group, but not in the prednisolone groups. In conclusion, triamcinolone induced type IIb fiber atrophy, resulting in reduced respiratory muscle strength and a leftward shift of the forcefrequency curve. In contrast, 5 mg/kg prednisolone caused alterations in diaphragmatic contractile properties and histological changes without fiber atrophy. (J. Clin. Invest. 1993.

show abstract

Steroid myopathy in connective tissue disease

Cited by 244 publications

References 32 publications

Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

Corticosteroid effects on ventilator-induced diaphragm dysfunction in anesthetized rats depend on the dose administered

Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

Contact Info

Product

Resources

About