The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A case of steroid induced myopathy and peripheral polyneuropathy in patient with iatrogenic Cushing syndrome

의인성 쿠싱 증후군과 동반하여 발생한 말초 신경 병증 및 스테로이드 근병증 1예

Kim, Ji-Hoon;Kim, Mi-Jin;Seo, Young-Tak;Kim, Kwang-Hyun;Park, A-Young;Ham, Young-Hwan
김지훈;김미진;서영탁;김광현;박아영;함영환

  • Published : 20060700
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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.

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.

Keywords

References

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