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[Rhabdomyolysis in patients treated by corticosteroids for acute asthma in intensive care unit]
1Service de médecine interne, faculté de médecine SMBH, UMR1125, LI2P, université Paris 13, hôpital universitaire Seine-Saint-Denis, AP-HP Sorbonne Paris Cité, 93000 Bobigny, France.
Introduction:
Acute muscle involvement is an infrequent complication of corticosteroids, characterized by muscle weakness and a rhabdomyolysis, rapidly regressive after withdrawal of corticosteroids.
Case Report:
We report the case of a woman admitted in intensive care unit for acute severe asthma, treated with high doses of methylprednisolone. Serum CPK level raised with a peak at 28,160 UI/L (n<250 UI/L) at day 15, suggesting acute rhabdomyolysis with renal failure. CPK rapidly normalized when corticosteroids were discontinued. Other causes of rhabdomyolysis were ruled out.
Conclusion:
This necrosing myopathy under high doses of corticosteroids has been described in patients with severe acute asthma. The mechanism of the muscle damage results from a combination of corticosteroids toxicity, respiratory acidosis and mechanic ventilation.
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