Acute myopathy secondary to oral steroid therapy in a 49-year-old man: a case report.

Muhammad A Khan,Eric Larson

doi:10.1186/1752-1947-5-82

Abstract

IntroductionAcute myopathy caused by oral corticosteroids is rare. We present a case of myopathy occurring after two doses of methylprednisolone. Typically, acute steroid myopathy occurs with therapy using intravenous corticosteroids at high doses. Acute myopathy developing very early in the course of treatment with oral corticosteroids has been reported only once in the literature. Corticosteroid therapy may be complicated by myopathy, usually chronic, after prolonged high-dose therapy. Acute myopathy caused by exogenous corticosteroids is rare, usually with intravenous corticosteroids at high doses.Case presentationA 49-year-old Caucasian man developed acute myopathy after taking oral methylprednisolone for only two days, 24 mg on day 1 and 20 mg on day 2. He discontinued the medication because of new-onset myalgias and lethargy on day 3 and was seen in our clinic four days after beginning therapy. He completely recovered in four weeks by discontinuing the corticosteroids.ConclusionAmong the many complications of corticosteroid therapy, acute myopathy is very rare. It requires prompt recognition and adjustment of therapy.

Highlights

Acute myopathy caused by oral corticosteroids is rare
Corticosteroids were introduced into clinical practice in 1948, and in 1958, Dubois [2] reported the first patient with myopathy resulting from iatrogenic corticosteroids
MacFarlane and Rosenthal [5] reported a case of a patient receiving IV hydrocortisone and developing myopathy manifested as difficulty weaning from a ventilator

Summary

Introduction

In 1932, Cushing [1] described myopathy as a clinical feature of hypercortisolism. Corticosteroids were introduced into clinical practice in 1948, and in 1958, Dubois [2] reported the first patient with myopathy resulting from iatrogenic corticosteroids. A basic metabolic panel and complete blood count results were normal He was sent home with ibuprofen 400 mg every six hours as needed for myalgias and instructions to call if his symptoms worsened. He was seen at a one-week scheduled return visit and reported significant improvement in muscle strength and decreased pain. He was seen again 30 days after initial presentation and was feeling fine and had resumed his normal active lifestyle, farming He continues to complain of intermittent foot pain, which is worse with activity, and he takes ibuprofen 400 mg as needed for relief

Discussion

Conclusion

Cushing H