Maryam Y Naim1, Ann M Reed. 1. Division of Pediatric Rheumatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Abstract
OBJECTIVE: Steroid myopathy can occur in patients with juvenile dermatomyositis (JDM) receiving chronic steroid therapy. We report an elevation of serum muscle enzymes, normal strength by manual muscle testing (MMT), and electromyographic (EMG) findings of steroid myopathy in children with JDM. METHODS: We prospectively studied children with JDM with a history of chronic steroid use (> 3 mo) and ongoing inflammatory myositis who were referred to our institution. RESULTS: We identified 5/9 children with JDM receiving longterm high dose steroids who had muscle enzyme elevation with no definable weakness and EMG findings consistent with steroid myopathy. All subjects improved after withdrawal of their steroid therapy. CONCLUSION: Longterm high dose steroids may lead to steroid myopathy with muscle enzyme elevation, previously reported only with acute steroid myopathy. We recommend that muscle derived enzyme levels should not be used to differentiate steroid myopathy from inflammatory myopathies.
OBJECTIVE:Steroidmyopathy can occur in patients with juvenile dermatomyositis (JDM) receiving chronic steroid therapy. We report an elevation of serum muscle enzymes, normal strength by manual muscle testing (MMT), and electromyographic (EMG) findings of steroidmyopathy in children with JDM. METHODS: We prospectively studied children with JDM with a history of chronic steroid use (> 3 mo) and ongoing inflammatory myositis who were referred to our institution. RESULTS: We identified 5/9 children with JDM receiving longterm high dose steroids who had muscle enzyme elevation with no definable weakness and EMG findings consistent with steroidmyopathy. All subjects improved after withdrawal of their steroid therapy. CONCLUSION: Longterm high dose steroids may lead to steroidmyopathy with muscle enzyme elevation, previously reported only with acute steroidmyopathy. We recommend that muscle derived enzyme levels should not be used to differentiate steroidmyopathy from inflammatory myopathies.
Authors: Matthew B McCullough; Zachary J Domire; Ann M Reed; Shreyasee Amin; Steven R Ytterberg; Qingshan Chen; Kai-Nan An Journal: Muscle Nerve Date: 2011-02-11 Impact factor: 3.217
Authors: Judith Wienke; Claire T Deakin; Lucy R Wedderburn; Femke van Wijk; Annet van Royen-Kerkhof Journal: Front Immunol Date: 2018-12-18 Impact factor: 7.561