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Focal myopathy associated with chronic intramuscular injection of piritramide
P Y Van den Bergh1, L Guettat, B C Vande Berg
1Department of Neurology, Cliniques Universitaires St-Luc, University of Louvain, Brussels, Belgium.
Abstract:
We report a patient in whom chronic intramuscular piritramide led to a focal fibrotic myopathy. Since piritramide myotoxicity has never been reported, we have studied its effect on rat skeletal muscle. Chronic intramuscular piritramide led to fibrous connective tissue replacement of rat skeletal muscle, similar to that found in the patient's muscle. Although the pathogenetic mechanism of piritramide myopathy is unclear, we caution against prolonged intramuscular use of piritramide to prevent this potentially debilitating adverse effect.
Insights
Chronic use of piritramide injections can cause fibrotic myopathy, a condition where muscle is replaced by fibrous tissue. This study observed similar effects in rats, cautioning against prolonged piritramide use.
Area of Science:
- Neurology
- Pathology
- Pharmacology
Background:
- Piritramide is an opioid analgesic.
- Myotoxicity of piritramide has not been previously reported.
- Investigating potential adverse effects of piritramide is crucial for patient safety.
Observation:
- A patient developed focal fibrotic myopathy following chronic intramuscular piritramide administration.
- Experimental study on rat skeletal muscle was conducted to investigate piritramide myotoxicity.
- Muscle tissue samples were analyzed for pathological changes.
Findings:
- Chronic intramuscular piritramide administration resulted in the replacement of skeletal muscle with fibrous connective tissue in rats.
- The observed fibrotic changes in rat muscle mirrored those found in the patient.
- This suggests a potential myotoxic effect of piritramide.
Implications:
- Prolonged intramuscular piritramide use may lead to debilitating fibrotic myopathy.
- The findings warrant caution regarding the long-term administration of piritramide via intramuscular injection.
- Further research is needed to elucidate the pathogenetic mechanism of piritramide-induced myopathy.