ERJ
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shee, C.D.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Shee, C.D.
Eur Respir J 2003; 21:377-378
Copyright ©ERS Journals Ltd 2003

Muscle weakness after short course of steroids

C.D. Shee

Queen Mary's Hospital, Sidcup, UK

To the Editor:

Nava et al. 1 have shown acute weakness of respiratory and skeletal muscles after a short course of methylprednisolone given for acute lung rejection after transplantation. As many chest physicians commonly use other corticosteroids, it is interesting to compare equivalent doses. Over a 5-day course of methylprednisolone 1 a 70 kg male would have received ~3.9 g. This is approximately equivalent to 4.9 g prednisolone or 19.5 g hydrocortisone 2.

I have previously suggested there is a dose effect with hydrocortisone in causing myopathy in ventilated asthmatics, with weakness more likely if >5 g hydrocortisone was used 3. Those patients were paralysed with neuromuscular blocking agents (which might predispose to myopathy), but severe weakness has also been described with 10.0 g hydrocortisone over 10 days in a nonparalysed ventilated asthmatic 4. Methylprednisolone is often given in doses of 1.0 g and theoretically even 2 days treatment (equivalent to 10.0 g hydrocortisone) might be enough to cause weakness. Nava et al. 1 have usefully highlighted the need to be aware of acute muscle weakness following high-dose steroids.

References

  1. Nava S, Fracchia C, Callegari G, Ambrosino N, Barbarito N, Felicetti G. Weakness of respiratory and skeletal muscles after a short course of steroids in patients with acute lung rejection. Eur Respir J 2002;20:497–499.[Abstract/Free Full Text]
  2. British National Formulary 43. British Medical Association and Royal Pharmaceutical Society of Great BritainLondon, Royal Pharmaceutical Society of Great Britain, 2002; p. 343.
  3. Shee CD. Risk factors for hydrocortisone myopathy in acute severe asthma. Respir Med 1990;84:229–233.[ISI][Medline] [Order article via Infotrieve]
  4. Knox AJ, Mascie-Taylor BH, Muers MF. Acute hydrocortisone myopathy in acute severe asthma. Thorax 1986;41:411–412.[ISI][Medline] [Order article via Infotrieve]




This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shee, C.D.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Shee, C.D.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS