Steroid myopathy: Incidence and detection in a population with asthma

Bowyer, Suzanne L.; LaMothe, Michael P.; Hollister, J. Roger

doi:10.1016/0091-6749(85)90708-0

Cited by 186 publications

(98 citation statements)

References 19 publications

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“…Additionally, in some cross-sectional studies of patients with COPD, prior corticosteroid treatment has not been found to be related to strength or body composition [5,32]. Of note is that other investigators have also failed to identify detrimental effects of steroids on quadriceps [11] or deltoid strength [12] in asthma patients treated with maintenance doses v40 mg?day -1 of prednisolone. It is possible that steroid treatment could have caused a reduction in muscle endurance rather than strength.…”

Section: Significance Of the Findingsmentioning

confidence: 99%

“…A reduction in diaphragm strength has also been demonstrated, following the administration of high-dose methyl prednisolone to treat episodes of acute rejection occurring after lung transplantation [10]. However, two studies in asthma patients have not found evidence of muscle weakness in patients treated with maintenance doses v40 mg?day -1 of prednisolone [11,12]. In healthy subjects, a 2-week course of 20 mg prednisolone o.d.…”

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confidence: 99%

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Acute effect of oral steroids on muscle function in chronic obstructive pulmonary disease

Hopkinson

Man²,

Dayer³

et al. 2004

European Respiratory Journal

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Prospective data to support the hypothesis that corticosteroids are a significant cause of muscle weakness in patients with chronic obstructive pulmonary disease (COPD) are lacking.The authors studied respiratory and quadriceps muscle function, using both volitional techniques and magnetic nerve stimulation, as well as measuring metabolic parameters during incremental cycle ergometry, in 25 stable COPD patients. The forced expiratory volume in one second was 37.6¡21.4 % predicted, before and after a 2-week course of o.d. prednisolone 30 mg. Quadriceps strength was also assessed in 15 control patients on two occasions.Only two patients met the British Thoracic Society definition of steroid responsiveness. There was no change either in sniff transdiaphragmatic pressure (pre: 96.8¡19.7 cmH 2 O; post: 98.6¡22.4 cmH 2 O) or in twitch transdiaphragmatic pressure elicited by bilateral anterolateral magnetic phrenic-nerve stimulation (pre: 16.8¡9.1 cmH 2 O; post: 17.9¡10 cmH 2 O). Quadriceps twitch force did not change significantly either in the steroid group (pre: 9.5¡3.1 kg; post: 8.9¡3.7 kg) or in the control patients (pre: 8.1¡2.7 kg; post: 7.9¡2.2 kg). There were no changes in either peak or isotime ventilatory and metabolic parameters during exercise.In conclusion, in stable patients with chronic obstructive pulmonary disease, a 2-week course of 30 mg prednisolone daily does not cause significant skeletal muscle dysfunction or alter metabolic parameters during exercise.

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Section: Significance Of the Findingsmentioning

confidence: 99%

mentioning

confidence: 99%

Acute effect of oral steroids on muscle function in chronic obstructive pulmonary disease

Hopkinson

Man²,

Dayer³

et al. 2004

European Respiratory Journal

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“…Postoperative reduction in IEX and IFX was similar and increases over time were parallel. Chronic preoperative inactivity, psychological factors, steroid myopathy and drug effects may reduce skeletal muscle function in HLT patients [34].…”

Section: Skeletal Muscle Functionmentioning

confidence: 99%

“…Some of these antedate the procedure, such as age of onset and duration of the pretransplant illness, as well as physical deconditioning and psychological factors associated with long-term debilitation [4][5][6]. Further postoperative negative influences on recovery could arise from cardiac denervation [7], the short-and long-term complications of allograft transplantation, and the adverse reactions of long-term immunosuppression [34]. Reduction in exercise capacity has been related to acute and chronic anaemia.…”

Section: Exercise Tolerancementioning

confidence: 99%

Time course of exercise capacity, skeletal and respiratory muscle performance after heart-lung transplantation

Ambrosino

Bruschi

Callegari

et al. 1996

European Respiratory Journal

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T Ti im me e c co ou ur rs se e oof f e ex xe er rc ci is se e c ca ap pa ac ci it ty y, , s sk ke el le et ta al l a an nd d r re es sp pi ir ra at to or ry y m mu us sc cl le e p pe er rf fo or rm ma an nc ce e a af ft te er r h he ea ar rt t--l lu un ng g t tr ra an ns sp pl la an nt ta at ti io on n N. Ambrosino*, C. Bruschi, G. Callegari, S. Baiocchi, G. Felicetti, C. Fracchia, C. RampullaTime course of exercise capacity, skeletal and respiratory muscle performance after heart-lung transplantation. N. Ambrosino, C. Bruschi, G. Callegari, S. Baiocchi, G. Felicetti, C. Fracchia, C. Rampulla. ERS Journals Ltd 1996. ABSTRACT: Recipients of heart-lung transplantation (HLT) show reduced exercise capacity due to several pre-and postsurgical factors. The aim of this study was to evaluate the time course of exercise capacity, and skeletal and respiratory muscle performance in 11 patients (5 females and 6 males; age (mean±SD) 38±13 yrs) undergoing HLT. All of the patients were admitted to our institution for a rehabilitation programme after surgery, and were followed-up for 18 months. On admission, at discharge after an in-patient rehabilitation programme, and every 6 months, patients underwent evaluation of: lung function values; incremental treadmill exercise, 6 min walking distance (6-MWD); maximal inspiratory and expiratory pressures (MIP and MEP, respectively); and peak torque of isokinetic contraction of leg flexor and extensor muscles (IFX and IEX, respectively).On admission, patients had: reduced lung volumes as assessed by vital capacity (VC) (60±15% of predicted); reduced exercise capacity as assessed by peak oxygen consumption (V ' 'O 2 ,peak) (40±12% pred); reduced skeletal and respiratory muscle performance as assessed by IEX, IFX (48±16 and 28±12 Newton-metres (N×m), respectively) and by MIP and MEP (54±21 and 58±19 cmH 2 O, respectively). Ten patients completed the rehabilitation programme. At discharge, no significant change in dynamic and static lung volumes was observed. However, nonsignificant increases in MIP, MEP, IEX, IFX, 6-MWD and V ' 'O 2 ,peak were recorded. After 6 and 12 months, indices of skeletal and respiratory muscle function and V ' 'O 2 ,peak improved further, but still remained lower than normal values.We conclude that in patients with heart-lung transplantation, skeletal and respiratory muscle function and exercise performance are reduced after surgery, that they may improve with time but are still less than normal after 18 months.

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“…It occurs in up to 50% of all patients requiring prolonged steroid use and is more commonly associated with the administration of fluorinated steroids [62,63]. Clinical features include proximal and symmetrical muscle atrophy and weakness that may affect both upper and lower extremities.…”

Section: Steroid Myopathymentioning

confidence: 99%