Corticosteroid-induced myopathy of the respiratory muscles.

摘要: Corticosteroids may cause myopathy of both skeletal and respiratory muscles. This is specific clinical importance in patients with chronic obstructive pulmonary disease (COPD), who already have impaired muscle function. After treatment fluorinated steroids, side-effects occur more frequently are worse compared to non-fluorinated steroids. Acute atrophy caused by short-term high-dose corticosteroid administration, resulting rhabdomyolysis, diffuse weakness severe dyspnoea. In contrast, occurs after prolonged corticosteroids, results proximal type IIb fibre atrophy. The pathophysiology steroid unknown, but reduction protein synthesis increased glycogen accumulation play a major role. Animal models demonstrated weakening the diaphragm decrease body mass administration. humans, peripheral strength, an elevation urinary creatine excretion selective be observed. Treatment corticosteroid-induced consists tapering dose steroids or switching