Myopathy with thick filament (myosin) loss following prolonged paralysis with vecuronium during steroid treatment

A 20-year-old female hospitalized with status asthmaticus was treated with bronchodilators, antibiotics, and high-dose corticosteroids, and was paralyzed with vecuronium for 10 days to facilitate mechanical ventilation. When this was discontinued, she was found to have a flaccid quadriplegia with ar...

Full description

Saved in:
Bibliographic Details
Published inMuscle & nerve Vol. 14; no. 11; p. 1131
Main Authors Danon, M J, Carpenter, S
Format Journal Article
LanguageEnglish
Published United States 01.11.1991
Subjects
Adult
Female
Histocytochemistry
Humans
Methylprednisolone - adverse effects
Muscles - chemistry
Muscles - ultrastructure
Muscular Diseases - chemically induced
Muscular Diseases - metabolism
Muscular Diseases - pathology
Myosins - ultrastructure
Paralysis - chemically induced
Respiration, Artificial
Status Asthmaticus - drug therapy
Status Asthmaticus - therapy
Vecuronium Bromide - adverse effects
Online AccessGet more information

Cover

More Information
Summary:A 20-year-old female hospitalized with status asthmaticus was treated with bronchodilators, antibiotics, and high-dose corticosteroids, and was paralyzed with vecuronium for 10 days to facilitate mechanical ventilation. When this was discontinued, she was found to have a flaccid quadriplegia with areflexia and 4-fold elevation in serum creatine kinase. A muscle biopsy showed extensive loss of thick (myosin) myofilaments, sometimes in core-like distribution, with relative preservation of thin (actin) filaments and Z-discs. Muscle strength returned to normal after 2 months. The pathological lesion in this patient's muscle fibers resemble those in rats treated with high doses of corticosteroids following denervation.
ISSN:0148-639X
1097-4598
DOI:10.1002/mus.880141115