의인성 쿠싱 증후군과 동반하여 발생한 말초 신경 병증 및 스테로이드 근병증 1예
A case of steroid induced myopathy and peripheral polyneuropathy in patient with iatrogenic Cushing syndrome
0
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
스테로이드 근병증은 의인성 쿠싱 증후군의 합병증 중의 하나이다. 주로 근력 약화를 주 증상으로 하며, 혈중 근육 효소(CK, aldolase, GOT)가 증가되며, 근조직 검사에서 특이적으로 2형 근섬유의 위축을 특징으로 하는 질환이다. 스테로이드의 사용 중단과 함께 등장성 운동을 시행하면 근력 약화를 지연할 수 있다. 본 저자들은 의인성 쿠싱 증후군 환자에서 임상양상, 혈청학적 검사, 신경전도 및 근조직 검사를 통하여 말초신경병증과 함께 동반된 스테로이드 근병증을 진단하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Myopathy is a well known side effect of corticosteroid therapy. We report a case of iatrogenic steroid therapy induced myopathy in a 79-year-old female who had taken steroids for more than three years due to treatment for degenerative osteoarthritis. She complained of severe proximal muscle wasting and lower extremities weakness. Also, she had typical features of Cushing syndrome such as moon face, buffalo hump and easy bruising. Needle electromyogram showed no abnormal spontaneous activities in both lower extremities, but peripheral nerve conduction study showed motor conduction defect of both deep peroneal and tibial nerves. And, low SNAP (sensory nerve action potential) of both superficial peroneal and sural nerves, which were compatible with peripheral polyneuropathy in both lower extremities. The muscle biopsy revealed a pronounced muscle fiber atrophy, fatty degenerative change and selective type 2 fiber depletion on ATPase staining in pH 9.4 buffer. She was treated isotonic exercise physical therapy and slowly improved. After three months later, she complained sudden onset of chest discomfort and died due to congestive heart failure.(Korean J Med 71:103-107, 2006)
참고문헌 (16)
- "Endocrine neuromyopathies", 15, pp.673~696 (1997)
- "Endocrine myopathies", 18, pp.203~213 (2000)
- "Factors influencing the development of steroid-induced myopathies", 138, pp.62~72 (1966)
- "Endocrine neuromyopathies", 15, pp.673~696 (1997)
- "Endocrine myopathies", 6, pp.575~592 (1988)
- "insidious cause of muscle weakness", pp.207 213~210 215 (1982)
- "의인성 쿠싱 증후군에서 수반된 스테로이드 근병증 1예", 11, pp.467~470 (1993)
- "Steroid myopathy:report of five cases occurring during treatment of rheumatic fever", 29, pp.26~36 (1962)
- "effect of corticosteroids on final results", vig(s pj jr), pp.263~277 (1964)
- "Steroid myopathy", 72, pp.207~215 (1982)
- "Muscle protein synthesis in steroid-induced proximal myopathy:a case report", 12, pp.378~381 (1989)
- "Steroid myopathy in connective tissue disease", 61, pp.485~492 (1976)
- "Prolonged neurogenic weakness in patients requiring mechanical ventilation for acute airflow limitation", 101, pp.1413~1416 (1992)
- "Acute myopathy during treatment of status asthmaticus with corticosteroids and steroidal muscle relaxants", 102, pp.510~514 (1992)
- "a complication of treatment with steroids", (ndepolarizing blocking agents), pp.2082~42 2087 (1992)
- "의인성 쿠싱 증후군에 동반된 스테로이드 근병증 1예", 17, pp.275~279 (2002)