Marco Alessandro Minetto1,2, Valentina D'Angelo3, Emanuela Arvat, Santosh Kesari4. 1. Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy. marco.minetto@unito.it. 2. Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy. marco.minetto@unito.it. 3. Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, Turin, Italy. 4. Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute and Pacific Neuroscience Institute, Santa Monica, CA, USA.
Abstract
INTRODUCTION: Steroid myopathy is a well-known sign of endogenous Cushing's syndrome as well as a side effect of glucocorticoid administration. The clinical finding of muscle weakness and the clinical inspection of the muscle size are the most commonly used diagnostic tools, sometimes in combination with needle electromyography, but there are no means to detect the myopathy before the appearance of clinical or electrodiagnostic signs. Until now, no guidelines have been produced for a disease-specific evaluation of muscle impairment in patients with Cushing's syndrome. REVIEW: We reviewed the measurement properties and limitations of the following tools that are currently adopted in clinical research and routine care for diagnosis and monitoring of steroid myopathy: muscle strength assessment; needle biopsy; intramuscular and surface electromyography; laboratory assays; muscle mass assessments (through bioelectrical impedance analysis, dual-energy X-ray absorptiometry, and computed tomography). CONCLUSIONS: We suggest that the management of steroid myopathy patients in clinical research and practice would benefit from a multidisciplinary approach based on the combined assessment of muscle mass, strength, and performance. However, further studies are required to establish an operational definition of steroid myopathy and to identify population-specific criteria for diagnosis of the myopathic process.
INTRODUCTION:Steroidmyopathy is a well-known sign of endogenous Cushing's syndrome as well as a side effect of glucocorticoid administration. The clinical finding of muscle weakness and the clinical inspection of the muscle size are the most commonly used diagnostic tools, sometimes in combination with needle electromyography, but there are no means to detect the myopathy before the appearance of clinical or electrodiagnostic signs. Until now, no guidelines have been produced for a disease-specific evaluation of muscle impairment in patients with Cushing's syndrome. REVIEW: We reviewed the measurement properties and limitations of the following tools that are currently adopted in clinical research and routine care for diagnosis and monitoring of steroidmyopathy: muscle strength assessment; needle biopsy; intramuscular and surface electromyography; laboratory assays; muscle mass assessments (through bioelectrical impedance analysis, dual-energy X-ray absorptiometry, and computed tomography). CONCLUSIONS: We suggest that the management of steroidmyopathypatients in clinical research and practice would benefit from a multidisciplinary approach based on the combined assessment of muscle mass, strength, and performance. However, further studies are required to establish an operational definition of steroidmyopathy and to identify population-specific criteria for diagnosis of the myopathic process.
Authors: David L Kendler; Joao L C Borges; Roger A Fielding; Akira Itabashi; Diane Krueger; Kathleen Mulligan; Bruno M Camargos; Brian Sabowitz; Chih-Hsing Wu; Elaine W Yu; John Shepherd Journal: J Clin Densitom Date: 2013-10-16 Impact factor: 2.617
Authors: Ian Janssen; Richard N Baumgartner; Robert Ross; Irwin H Rosenberg; Ronenn Roubenoff Journal: Am J Epidemiol Date: 2004-02-15 Impact factor: 4.897
Authors: M A Minetto; C Caresio; M Salvi; V D'Angelo; N E Gorji; F Molinari; G Arnaldi; S Kesari; E Arvat Journal: J Endocrinol Invest Date: 2018-11-15 Impact factor: 4.256