A Case with Myopathy Involving the Pharynx as well as Proximal Limb Muscles Associated with Corticosteroid Abuse
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We report a patient who developed dysphagia related to myopathyafter corticosteroid abuse. A 62-year-oldmale patient was referred to the outpatient department of rehabilitation with a persistent swallowing difficulty. The patient complained of swallowing difficulty, such as pharyngolaryngeal weakness, residualsense,and aspiration after swallowing. A videofluoroscopic swallowing study revealed a large amount ofresidue in the vallecular pouch and piriform sinus. Laryngeal penetrations and nasal penetration werefound in all the swallowing materials. Further detailed history taking revealed that the patient has beenreceiving injected dexamethasone once or twice a week for 30 years. He showed some adverse effects ofsteroid use, such as generalized muscle weakness and skin changes. The needle electromyography demonstratedmyopathic pattern. His dysphagia symptoms were considered as steroid-induced myopathy. Thiscase suggests that physicians should be alert to potential cases of dysphagia and consider steroid-inducedmyopathy in the differential diagnosis of patients with dysphagia.
Abstract
We report a patient who developed dysphagia related to myopathyafter corticosteroid abuse. A 62-year-oldmale patient was referred to the outpatient department of rehabilitation with a persistent swallowing difficulty. The patient complained of swallowing difficulty, such as pharyngolaryngeal weakness, residualsense,and aspiration after swallowing. A videofluoroscopic swallowing study revealed a large amount ofresidue in the vallecular pouch and piriform sinus. Laryngeal penetrations and nasal penetration werefound in all the swallowing materials. Further detailed history taking revealed that the patient has beenreceiving injected dexamethasone once or twice a week for 30 years. He showed some adverse effects ofsteroid use, such as generalized muscle weakness and skin changes. The needle electromyography demonstratedmyopathic pattern. His dysphagia symptoms were considered as steroid-induced myopathy. Thiscase suggests that physicians should be alert to potential cases of dysphagia and consider steroid-inducedmyopathy in the differential diagnosis of patients with dysphagia.
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