Document Detail


Corticosteroid-induced myopathy mimicking therapy-resistant asthma.
MedLine Citation:
PMID:  17941287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Therapy-resistant asthma is an important clinical problem. However, before considering asthma truly therapy resistant, it is essential to exclude diagnoses that may masquerade as therapy-resistant asthma, such as vocal cord dysfunction and recurrent aspiration, as well as factors related to loss of asthma control, including poor compliance, exposure to allergens, and sinusitis. Corticosteroid-induced myopathy may be an unrecognized but potentially important consideration in both settings. OBJECTIVES: To describe a patient with corticosteroid-induced myopathy complicating recurrent exacerbations of asthma, which presented with persistently reduced airflow that mimicked therapy-resistant asthma. METHODS: A 20-year-old Japanese woman with severe intractable asthma who had a history of near-fatal attacks was admitted with recurrent asthma exacerbations that required long-term systemic corticosteroids. RESULTS: Wheezing episodes decreased but airflow limitation persisted, which was due to not only uncontrolled asthma but also corticosteroid-induced myopathy. Myopathy prevented the adequate use of inhalers, which in turn complicated the tapering of corticosteroids, leading to a vicious cycle. Careful and gradual reduction of corticosteroid dose, while continuing systemic administration of nonsteroidal antiasthma medications, resulted in a resolution of clinical and electromyographic signs of myopathy and pulmonary function abnormalities. CONCLUSIONS: Corticosteroid-induced myopathy can masquerade as therapy-resistant asthma and can cause poor asthma control.
Authors:
Masafumi Yamaguchi; Akio Niimi; Masayoshi Minakuchi; Hisako Matsumoto; Koichi Shimizu; Kazuo Chin; Michiaki Mishima
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology     Volume:  99     ISSN:  1081-1206     ISO Abbreviation:  Ann. Allergy Asthma Immunol.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-18     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503580     Medline TA:  Ann Allergy Asthma Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  371-4     Citation Subset:  IM    
Affiliation:
Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects*,  therapeutic use
Adult
Asthma / diagnosis,  drug therapy*,  physiopathology
Diagnosis, Differential
Drug Resistance
Female
Forced Expiratory Volume
Humans
Immunoglobulin E / blood
Muscular Diseases / chemically induced*,  diagnosis
Peak Expiratory Flow Rate
Spirometry
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 37341-29-0/Immunoglobulin E

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