Steroid-induced Disease: A Case Report and the Literatures Review_West China Medical Journal

Authors：

 LiJinhong , DengQian , ZhangYongzhi ,  ChenQin

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ChenQin, Email: chenqin8124@gmail.com

Keywords：

Triamcinolone acetonide; Glucocorticoid; Myopathy

DOI：

10.7507/1002-0179.20160060

Video：

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Objective To investigate the characteristics, pathogenesis and treatment of steroid-induced diseases. Methods The clinical data of one patient with steroid-induced disease diagnosed and treated on October 20th, 2015 were analyzed retrospectively. Results This patient was admitted to the hospital because of "20 years of pain in the left lower limb and 6 months after the recurrence of the muscle atrophy". After previous diagnosis of sciatica, the patient abused hormone therapy (triamcinolone), and had limb muscle weakness, atrophy, proximal limb muscle strength of grade 5-, creatine kinase 53 U/L, and electromyography suggested neurogenic damage of the limbs. We considered steroid myopathy, and required immediate stop of hormone. The patient's symptoms gradually improved. Conclusion Steroid myopathy and the pathogenesis of glucocorticoid abuse are closely related. Regulating the use of hormone, timely detection of complication of steroid myopathy and stopping the use of sugar cortical hormone are the most important measures to avoid the disease and improve the prognosis.

Citation： LiJinhong, DengQian, ZhangYongzhi, ChenQin. Steroid-induced Disease: A Case Report and the Literatures Review. West China Medical Journal, 2016, 31(2): 216-219. doi: 10.7507/1002-0179.20160060 Copy

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14.	Mignon M, Leveque L, B onnelE, et al. Does glutamine supplementation decrease the response of muscle glutamine synthesis to fasting in muscle in adult and very old rats?[J]. JPEN J Parenter Enteral Nutr, 2007, 31(1):26-31.
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16.	朱汉民. 活性维生素D和骨质疏松症防治[J]. 中华医学信息导报, 2005, 20(17):22.
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18.	Urso ML, Clarkson PM, Hittel D, et al. Changes in ubiquitin proteasome pathway gene expression in skeletal muscle with exercise and statins[J]. Arterioscler Thromb Vasc Biol, 2005, 25(12):2560-2566.
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1. Soldatos CR, Dikeos DG, Paparrigopoulos TJ. Athens insomnia scale:validation of an instrument based on ICD-10 criteria[J]. J Psychosom Res, 2000, 48(6):555-560.
2. Batchelor TT, Taylor LP, Thaler HT, et al. Steroid myopathy in cancer patients[J]. Neurology, 1997, 48(5):1234-1238.
3. Pereira RM. Freire de Carvalho J. Glucocorticoid-induced myopathy[J]. Joint Bone Spine, 2011, 78(1):41-44.
4. Guis S, Mattéi JP, Lioté F. Drug-induced and toxic myopathies[J]. Best Pract Res Clin Rheumatol, 2003, 17(6):877-907.
5. 周磊, 赵重波, 朱雯华, 等. 类固醇肌病的临床和病理特点分析(附10例报道)[J]. 中国临床神经科学, 2011, 19(6):583-587.
6. 程伟进, 胡红玲.类固醇肌病8例报道[C]//2012年浙江省神经病学学术年会论文集, 嘉兴:浙江省科学技术协会, 2012:96.
7. 王运美. 肾上腺皮质类固醇肌病20例临床分析[J]. 现代医药卫生, 2000, 16(5):437.
8. 刘吉良, 张凤芝. 药源性类固醇肌病(2例肌活检病理及文献复习)[J]. 脑与神经疾病杂志, 1995(3):180.
9. Owczarek J, Jasińska M, Orszulak-Michalak D. Drug-induced myopathies. An overview of the possible mechanisms[J]. Pharmacol Rep, 2005, 57(1):23-34.
10. Minetto MA, Lanfranco F, Motta G, et al. Steroid myopathy:some unresolved issues[J]. J Endocrinol Invest, 2011, 34(5):370-375.
11. 沈定国. 肌肉疾病[M]. 北京:人民军医出版社, 2007:381.
12. Kanda F, Okuda S, Matsushita T, et al. Steroid myopathy:pathogenesis and effects of growth hormone and insulin-like growth factor-I administration[J]. Horm Res, 2001, 56(Suppl 1):24-28.
13. Schakman O, Gilson H, Kali SS, et al. Mechanisms of muscle atrophy induced by glucocorticoids[J]. Horm Res, 2009, 72(Suppl1):36-41.
14. Mignon M, Leveque L, B onnelE, et al. Does glutamine supplementation decrease the response of muscle glutamine synthesis to fasting in muscle in adult and very old rats?[J]. JPEN J Parenter Enteral Nutr, 2007, 31(1):26-31.
15. Menezes LG, Sobreira C, Neder L, et al. Creatine supplementation attenuates corticosteroid-induced muscle wasting and impairment of exercise performance in rats[J]. J Appl Physiol (1985), 2007, 102(2):698-703.
16. 朱汉民. 活性维生素D和骨质疏松症防治[J]. 中华医学信息导报, 2005, 20(17):22.
17. Newton CJ, Ran G, Xie YX, et al. Statin-induced apoptosis of vascular endothelial cells is blocked by dexamethasone[J]. J Endocrinol, 2002, 174(1):7-16.
18. Urso ML, Clarkson PM, Hittel D, et al. Changes in ubiquitin proteasome pathway gene expression in skeletal muscle with exercise and statins[J]. Arterioscler Thromb Vasc Biol, 2005, 25(12):2560-2566.
19. Kino T, Tiulpakov A, Ichijo T, et al. G protein beta interacts with the glucocorticoid receptor and suppresses its transcriptional activity in the nucleus[J]. J Cell Biol, 2005, 169(6):885-896.
20. Miyata H, Genma T, Ohshima M, et al. Mitogen-activated protein kinase/extracellular signal-regulated protein kinase activation of cultured human dental pulp cells by low-power gallium-aluminium-arsenic laser irradiation[J]. Int Endod J, 2006, 39(3):238-244.
21. 黄平, 袁建琴, 刘承宜, 等. 光生物调节及糖皮质激素治疗类固醇肌病的前景[J]. 中国组织工程研究与临床康复, 2007, 11(22):4399-4404.

West China Medical Journal

Steroid-induced Disease: A Case Report and the Literatures Review

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