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Published on: October 25, 2018
Iatrogenic and toxic myopathies
Joern P Sieb1, Thomas Gillessen
1Section of Neurology, Max Planck Institute of Psychiatry, Kraepelinst 10, Munich D-80804, Germany. sieb@mpipsykl.mpg.de
Abstract:
There has been increasing awareness of the adverse effects of therapeutic agents and exogenous toxins on the structure and function of muscle. The resulting clinical syndrome varies from one characterized by muscle pain to profound myalgia, paralysis, and myoglobinuria. Because toxic myopathies are potentially reversible, their prompt recognition may reduce their damaging effects or prevent a fatal outcome. Interest in the toxic myopathies, however, derives not only from their clinical importance but also from the fact that they serve as useful experimental models in muscle research. Morphological and biochemical studies have increased our understanding of the basic cellular mechanisms of myotoxicity. Toxins may produce, for instance, necrotizing, lysosomal-related, inflammatory, anti-microtubular, mitochondrial, hypokalemia-related, or protein synthesis-related muscle damage.
Insights
Therapeutic agents and toxins can harm muscle, causing conditions from pain to paralysis. Prompt recognition of toxic myopathies is crucial for reversibility and preventing severe outcomes.
Area of Science:
- Neurology
- Toxicology
- Cellular Biology
Background:
- Increasing awareness of adverse effects of therapeutic agents and exogenous toxins on muscle structure and function.
- Clinical syndromes range from myalgia to paralysis and myoglobinuria.
- Toxic myopathies are potentially reversible, emphasizing the need for prompt recognition.
Purpose of the Study:
- To highlight the clinical importance of toxic myopathies.
- To underscore their utility as experimental models in muscle research.
- To review the morphological and biochemical mechanisms of myotoxicity.
Main Methods:
- Review of existing literature on toxic myopathies.
- Analysis of morphological and biochemical studies.
- Categorization of muscle damage mechanisms induced by toxins.
Main Results:
- Toxins can induce various forms of muscle damage, including necrotizing, lysosomal-related, inflammatory, anti-microtubular, mitochondrial, hypokalemia-related, and protein synthesis-related.
- Understanding these mechanisms enhances knowledge of basic cellular processes in myotoxicity.
- Prompt diagnosis can mitigate damage and prevent fatal outcomes.
Conclusions:
- Toxic myopathies represent a significant clinical challenge with potentially reversible outcomes.
- They serve as valuable models for studying fundamental muscle biology and pathology.
- Further research into specific toxin-induced mechanisms can improve patient management and therapeutic strategies.
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