Abstract
A case of acute myopathy was observed in the course of treatment of respiratory failure with mechanical ventilation combined with prolonged neuromuscular blockade and administration of corticosteroids. A muscle biopsy revealed degeneration of muscle fibres. Electron microscopy showed loss of thick filaments as well as nemaline rods, vacuoles and cytoplasmic bodies. The mitochondria were increased in number, many harbouring paracrystalline inclusions, which were hitherto unknown in this condition.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bachmann P, Gaussorgues P, Piperno D, Jaboulay J-M, Jean G, Boyer F, Robert D (1988) Hydrocortisone and pancuronium bromide. Acute myopathy during status asthmaticus. Crit Care Med 16: 731
Barcroft H (1963) Circulation in skeletal muscle. In: Dow P, Hamilton P (eds) Handbook of Physiology, vol 2: American Physiological Society, Washington DC, pp 1353–1385
Bowman WC (1982) Non-relaxant properties of neuromuscular blocking drugs. Br J Anaesth 54: 147–160
Brun-Buisson C, Gherardi R (1988) Hydrocortisone and pancuronium bromide. Acute myopathy during status asthmaticus. Crit Care Med 16: 731–732
Carpenter S, Karpati G (1984) Pathology of skeletal muscle. Churchill Livingstone, New York, pp 592–597
Danon MJ, Carpenter S (1991) Myopathy with thick filament (myosin) loss following prolonged paralysis with vecuronium during steroid treatment. Muscle Nerve 14: 1131–1139
DuBois DC, Almond RR (1980) Disuse atrophy of skeletal muscle is associated with an increase in number of glucocorticoid receptors. Endocrinology 107: 1649–1651
DuBois DC, Almond RR (1981) A possible role for glucocorticoid in denervation atrophy. Muscle Nerve 4: 370–373
Engel AG (1966) Electron microscopic observations in thyrotoxic and corticosteroid-induced myopathies. Mayo Clin Proc 41: 785–796
Hirano M, Ott BR, Raps EC, Minetti C, Lennihan L, Libbey NP, Bonilla E, Hays AP (1992) Acute quadriplegic myopathy. A complication of treatment with steroids, nondepolarizing blocking agents, or both. Neurology 42: 2082–2087
Kaplan PW, Rocha W, Sanders DB, D'Souza B, Spock A (1986) Acute steroid-induced tetraplegia following status asthmaticus. Pediatrics 78: 121–123
Karpati G, Carpenter S, Eisen AA (1974) Experimental corelike lesions and nemaline rods. A correlative morphological and physiological study. Arch Neurol 27: 237–251
Karpati G, Carpenter S, Melmed C, Eisen AA (1974) Experimental ischemic myopathy. J Neurol Sci 23: 129–161
Ludden TM (1985) Pharmacokinetic interactions of the macrolide antibiotics. Clin Pharmacokinet 10: 63–79
MacFarlane IA, Rosenthal FD (1977) Severe myopathy after status asthmaticus. Lancet II: 615
Rowland LP, Blake DM, Hirano M, Di Mauro S, Schon EA, Hays AP, Devivo DC (1991) Clinical syndromes associated with ragged red fibers. Rev Neurol (Paris) 147: 467–473
Shoffner JM, Lott MT, Lezza AM, Seibel P, Ballinger SW, Wallace DC (1990) Myoclonic epilepsy and ragged-red fiber disease (MERRF) is associated with a mitochondrial DNA tRNALys mutation. Cell 61: 931–937
Sitwell LD, Weinshenker BG, Monpetit V, Reid D (1991) Complete ophthalmoplegia as a complication of acute corticosteroid- and pancuronium-associated myopathy. Neurology 41: 921–922
Waclawik AJ, Sufit RL, Beinlich BR, Schutta HS (1992) Acute myopathy with selective degeneration of myosin filaments following status asthmaticus treated with methylprednisolone and vecuronium. Neuromuscul Disord 2: 19–26
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Matsubara, S., Okada, T. & Yoshida, M. Mitochondrial changes in acute myopathy after treatment of respiratory failure with mechanical ventilation (acute relaxant-steroid myopathy). Acta Neuropathol 88, 475–478 (1994). https://doi.org/10.1007/BF00389502
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00389502