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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16.	朱漢民. 活性維生素D和骨質疏松癥防治[J]. 中華醫學信息導報, 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, 趙重波, 朱雯華, 等. 類固醇肌病的臨床和病理特點分析(附10例報道)[J]. 中國臨床神經科學, 2011, 19(6):583-587.
6. 程偉進, 胡紅玲.類固醇肌病8例報道[C]//2012年浙江省神經病學學術年會論文集, 嘉興:浙江省科學技術協會, 2012:96.
7. 王運美. 腎上腺皮質類固醇肌病20例臨床分析[J]. 現代醫藥衛生, 2000, 16(5):437.
8. 劉吉良, 張鳳芝. 藥源性類固醇肌病(2例肌活檢病理及文獻復習)[J]. 腦與神經疾病雜志, 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. 沈定國. 肌肉疾病[M]. 北京:人民軍醫出版社, 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. 朱漢民. 活性維生素D和骨質疏松癥防治[J]. 中華醫學信息導報, 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. 黃平, 袁建琴, 劉承宜, 等. 光生物調節及糖皮質激素治療類固醇肌病的前景[J]. 中國組織工程研究與臨床康復, 2007, 11(22):4399-4404.

West China Medical Journal

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

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