Scola Rosana Herminia, Pereira Eduardo Rafael, Lorenzoni Paulo José, Werneck Lineu César
Neuromuscular/Neurology Division, Internal Medicine Department, Hospital de Clínicas, Universidade Federal do Paraná, Rua General Carneiro 181, 80060-900 Curitiba, PR, Brazil.
Arq Neuropsiquiatr. 2007 Mar;65(1):82-6. doi: 10.1590/s0004-282x2007000100018.
Several drugs and toxic substances can cause muscular abnormalities and are frequent causes of acquired myopathies. We present a series of 32 patients, predominance of young adult patients, diagnosed with toxic myopathy. The most common substances inducing myopathy were corticosteroids (56.2%) followed by the propoxyphene, neuroleptics, zidovudine and drug-induced hypokalemia. The investigation showed normal serum creatine kinase levels in 65.4%, myopathic pattern of the needle electromyography in 40% and the more frequent histological diagnosis of the muscle biopsy was type 2 fiber atrophy (59.3%). Clinical features, etiology, course of the disease, serum levels of muscular enzymes, electromyographic features and, especially, muscle biopsy features are discussed.
几种药物和有毒物质可导致肌肉异常,是获得性肌病的常见病因。我们报告了一系列32例诊断为中毒性肌病的患者,以年轻成年患者为主。引起肌病最常见的物质是皮质类固醇(56.2%),其次是丙氧芬、抗精神病药物、齐多夫定和药物性低钾血症。调查显示,65.4%的患者血清肌酸激酶水平正常,40%的患者针极肌电图呈肌病模式,肌肉活检最常见的组织学诊断是2型纤维萎缩(59.3%)。本文讨论了临床特征、病因、病程、肌肉酶血清水平、肌电图特征,尤其是肌肉活检特征。