BACKGROUND: Glucocorticoids are an effective treatment of ulcerative colitis. The occurrence of steroid side effects depends on dosage and duration of steroid treatment. It may be a high as 80%. A rare side effect of glucocorticoid therapy is steroid induced myopathia. There exists an acute and a chronic form of steroid induced myopathia. Chronic steroid myopathia affects mainly the proximal musculature of the lower and upper extremities and leads to proximal muscle weakness. Histologically, an atrophy of type IIb-muscle fibers can be found. Chronic steroid myopathia occurs after prolonged treatment with higher doses of glucocorticoids. CASE REPORT: The case report describes a 25 year old male patient with left-sided ulcerative colitis who developed chronic steroid myopathia after several months of glucocorticoid treatment. After switching from systemic steroids to budesonide the symptoms of myopathia disappeared. Left-sided ulcerative colitis remained in remission. CONCLUSION: The case documents the disappearance of a severe steroid side effect after switching from a systemic steroid to budesonide.
BACKGROUND: Glucocorticoids are an effective treatment of ulcerative colitis. The occurrence of steroid side effects depends on dosage and duration of steroid treatment. It may be a high as 80%. A rare side effect of glucocorticoid therapy is steroid induced myopathia. There exists an acute and a chronic form of steroid induced myopathia. Chronic steroid myopathia affects mainly the proximal musculature of the lower and upper extremities and leads to proximal muscle weakness. Histologically, an atrophy of type IIb-muscle fibers can be found. Chronic steroid myopathia occurs after prolonged treatment with higher doses of glucocorticoids. CASE REPORT: The case report describes a 25 year old male patient with left-sided ulcerative colitis who developed chronic steroid myopathia after several months of glucocorticoid treatment. After switching from systemic steroids to budesonide the symptoms of myopathia disappeared. Left-sided ulcerative colitis remained in remission. CONCLUSION: The case documents the disappearance of a severe steroid side effect after switching from a systemic steroid to budesonide.
Authors: S Lichtiger; D H Present; A Kornbluth; I Gelernt; J Bauer; G Galler; F Michelassi; S Hanauer Journal: N Engl J Med Date: 1994-06-30 Impact factor: 91.245
Authors: T Andus; V Gross; I Caesar; H J Schulz; H Lochs; W D Strohm; M Gierend; A Weber; K Ewe; J Schölmerich Journal: Dig Dis Sci Date: 2003-02 Impact factor: 3.199