Naim Maryam Y, Reed Ann M
Division of Pediatric Rheumatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
J Rheumatol. 2006 Jul;33(7):1392-4.
Steroid myopathy can occur in patients with juvenile dermatomyositis (JDM) receiving chronic steroid therapy. We report an elevation of serum muscle enzymes, normal strength by manual muscle testing (MMT), and electromyographic (EMG) findings of steroid myopathy in children with JDM.
We prospectively studied children with JDM with a history of chronic steroid use (> 3 mo) and ongoing inflammatory myositis who were referred to our institution.
We identified 5/9 children with JDM receiving longterm high dose steroids who had muscle enzyme elevation with no definable weakness and EMG findings consistent with steroid myopathy. All subjects improved after withdrawal of their steroid therapy.
Longterm high dose steroids may lead to steroid myopathy with muscle enzyme elevation, previously reported only with acute steroid myopathy. We recommend that muscle derived enzyme levels should not be used to differentiate steroid myopathy from inflammatory myopathies.
接受长期类固醇治疗的幼年皮肌炎（JDM）患者可能会发生类固醇肌病。我们报告了JDM患儿血清肌肉酶升高、徒手肌力测试（MMT）显示肌力正常以及类固醇肌病的肌电图（EMG）表现。
我们对有慢性类固醇使用史（>3个月）且存在持续性炎症性肌炎并转诊至我院的JDM患儿进行了前瞻性研究。
我们确定了9例接受长期大剂量类固醇治疗的JDM患儿中有5例出现肌肉酶升高，无明确的肌无力，且EMG表现与类固醇肌病一致。所有受试者在停用类固醇治疗后均有改善。
长期大剂量类固醇可能导致类固醇肌病伴肌肉酶升高，此前仅在急性类固醇肌病中报道过。我们建议，不应使用肌肉源性酶水平来区分类固醇肌病和炎症性肌病。
