Two patients intubated for status asthmaticus and treated with high-dose intravenous steroids developed acute quadriplegic myopathy with selective loss of thick myosin filaments within 2 weeks.
Case Report (n=2)
High-dose intravenous steroid therapy in intubated asthmatic patients can lead to acute quadriplegic myopathy characterized by selective loss of thick myosin filaments, which is reversible over several months.
We studied two patients who were given high-dose intravenous steroid therapy and were intubated for status asthmaticus. Both became quadriplegic and wasted within 2 weeks. EMG had myopathic abnormalities. Muscle biopsy revealed severe atrophy of most muscle fibers, with disorganization of myofibrils and selective loss of thick (myosin) filaments. Immunohistologic stains for myosin isoforms confirmed the decrease or absence of this protein. Both patients clinically improved over several months.
Hirano et al. (Sun,) conducted a case report in Acute quadriplegic myopathy (n=2). High-dose intravenous steroid therapy and intubation was evaluated on Development of quadriplegia and myopathic abnormalities. Two patients intubated for status asthmaticus and treated with high-dose intravenous steroids developed acute quadriplegic myopathy with selective loss of thick myosin filaments within 2 weeks.