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Myasthenia gravis and steroid-induced myopathy of the respiratory muscles
B Vallet1, F Fourrier, J F Hurtevent
1Service de Réanimation Polyvalente, Hôpital B, CHRU, Lille, France.
Objective:
We report a case of corticosteroid-induced myopathy with involvement of respiratory muscles observed in a myasthenic patient.
Patient:
A 37-years-old woman, under corticosteroid treatment for two years for typical myasthenia gravis was admitted to ICU for acute myasthenic respiratory failure. Weaning from mechanical ventilation remained impossible despite 4 plasma exchanges and azathioprine. The patient exhibited a progressive 12 kg weight loss with muscular weakness and atrophy.
Measurements And Results:
Peripheral and diaphragmatic electromyography as well as histological study were consistent with a steroid-induced myopathy. Discontinuation of corticosteroid treatment was followed by a rapid weight gain with general improvement and allowed weaning from mechanical ventilation with a complete recovery.
Conclusion:
This case provides evidence that corticosteroid-induced myopathy may be observed in myasthenia gravis and may involve the respiratory muscles as well as the peripheral musculature.