Myopathic Complications of Medical Disease

ABSTRACT

Disorders of muscle may be primary or acquired secondary to an underlying medical condition. Clinical presentations range from asymptomatic elevations in creatine kinase to fatal rhabdomyolysis. Recognition of the underlying precipitant is imperative to effectively institute treatment for a potentially reversible process. The focus of this article is to review complications of systemic illness that result in signs and symptoms of muscle dysfunction. Myopathic complications of endocrinopathy, metabolic abnormalities, medications, critical illness, organ transplantation, infection, autoimmune conditions, malignancy, and toxin exposure are discussed, with an emphasis on the clinical features, electromyography, and muscle biopsy findings.

KEYWORDS

Myopathy - myositis - rhabdomyolysis - creatine kinase

REFERENCES

• 1 Duyff R F, Van den Bosch J, Laman D M, van Loon B J, Linssen W H. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study.  J Neurol Neurosurg Psychiatry. 2000;  68 750-755
• 2 Nickel S N, Frame B, Bebin J, Tourtellotte W W, Parker J A, Hughes B R. Myxedema neuropathy and myopathy: a clinical and pathologic study.  Neurology. 1961;  11 125-137
• 3 Turker H, Bayrak O, Gungor L et al.. Hypothyroid myopathy with manifestations of Hoffman's syndrome and myasthenia gravis.  Thyroid. 2008;  18(2) 259-262
• 4 Bhansali A, Chandran V, Ramesh J, Kashyap A, Dash R J. Acute myoedema: an unusual presenting manifestation of hypothyroid myopathy.  Postgrad Med J. 2000;  76 99-100
• 5 Kane M P, Busch R S. Drug-induced thyrotoxic periodic paralysis.  Ann Pharmacother. 2006;  40 778-781
• 6 Scott K R, Simmons Z, Boyer P J. Hypothyroid myopathy with a strikingly elevated serum creatine kinase level.  Muscle Nerve. 2002;  26 141-144
• 7 Madariaga M G, Gamarra N, Dempsey S, Barsano C P. Polymyositis-like syndrome in hypothyroidism: review of cases reported over the past twenty-five years.  Thyroid. 2002;  12(4) 331-336
• 8 Kodali V RR, Jeffcote B, Clague R B. Thyrotoxic periodic paralysis: a case report and review of the literature.  J Emerg Med. 1999;  17(1) 43-45
• 9 Nørrelund H, Hove K Y, Brems-Dalgaard E et al.. Muscle mass and function in thyrotoxic patients before and during medical treatment.  Clin Endocrinol. 1999;  51 693-699
• 10 Hiraga A, Mimura M, Kamitsukasa I. Isolated inferior rectus muscle myopathy due to Hashimoto's thyroiditis.  Intern Med. 2008;  47 1283-1284
• 11 Kung A W. Clinical review: Thyrotoxic periodic paralysis: a diagnostic challenge.  J Clin Endocrinol Metab. 2006;  91(7) 2490-2495
• 12 Hsieh M J, Lyu R K, Chang W N. Hypokalemic thyrotoxic periodic paralysis: clinical characteristics and predictors of recurrent paralytic attacks.  Eur J Neurol. 2008;  15 559-564
• 13 Ng W Y, Lui K F, Thai A C, Cheah J S. Absence of ion channels CACN1AS and SCN4A mutations in thyrotoxic hypokalemic periodic paralysis.  Thyroid. 2004;  14(3) 187-190
• 14 Patten B M, Bilezikian J P, Mallette L E, Prince A, Engel W K, Aurbach G D. Neuromuscular disease in primary hyperparathyroidism.  Ann Intern Med. 1974;  80 182-193
• 15 Riggs J E. Neurologic manifestations of electrolyte disturbances.  Neurol Clin. 2002;  20(1) 227-239
• 16 Jackson C E, Amato A A, Bryan W W, Wolfe G I, Sakhaee K, Barohn R J. Primary hyperparathyroidism and ALS: is there a relation?.  Neurology. 1998;  50(6) 1795-1799
• 17 Walsh R J, Amato A A. Toxic myopathies.  Neurol Clin. 2005;  23(2) 397-428
• 18 Schott G D, Wills M R. Myopathy in hypophosphataemic osteomalacia presenting in adult life.  J Neurol Neurosurg Psychiatry. 1975;  38 297-304
• 19 Aminoff M J. Neurology and General Medicine. Philadelphia, PA; Churchill Livingstone Elsevier 2008
• 20 Campistol J M. Uremic myopathy.  Kidney Int. 2002;  62 1901-1913
• 21 Mastaglia F L. Drug induced myopathies.  Pract Neurol. 2006;  6 4-13
• 22 Scola R H, Pereira E R, Lorenzoni P J, Werneck L C. Toxic myopathies: muscle biopsy features.  Arq Neuropsiquiatr. 2007;  65(1) 82-86
• 23 Bowman L, Armitage J, Bulbulia R, Parish S, Collins R. SEARCH Study Collaborative Group . Study of the effectiveness of additional reductions in cholesterol and homocysteine (SEARCH): characteristics of a randomized trial among 12064 myocardial infarction survivors.  Am Heart J. 2007;  154 815-823
• 24 Roten L, Schoenenberger R A, Krahenbuhl S, Schlienger R G. Rhabdomyolysis in association with simvastatin and amiodarone.  Ann Pharmacother. 2004;  38 978-981
• 25 Abdel-Hamid H, Oddis C V, Lacomis D. Severe hydroxychloroquine myopathy.  Muscle Nerve. 2008;  38 1206-1210
• 26 Owczarek J, Jasinska M, Orszulak-Michalak D. Drug-induced myopathies. An overview of the possible mechanisms.  Pharmacol Rep. 2005;  57 23-34
• 27 Wilbur K, Makowsky M. Colchicine myotoxicity: case reports and literature review.  Pharmacotherapy. 2004;  24(12) 1784-1792
• 28 Justiniano M, Dold S, Espinoza L R. Rapid onset of muscle weakness (rhabdomyolysis) associated with the combined use of simvastatin and colchicine.  J Clin Rheumatol. 2007;  13(5) 266-268
• 29 Pirzada N A, Medell M, Ali I. Colchicine induced neuromyopathy in a patient with normal renal function.  J Clin Rheumatol. 2001;  7(6) 374-376
• 30 Wahie S, Meggitt S J. Myotoxicity occurring with ciclosporin in a patient with atopic dermatitis.  Br J Dermatol. 2005;  153 1238
• 31 Khan S, El-Dars L, Holt P J. Musculoskeletal and myotoxic side-effects in a patient treated for psoriasis.  Br J Dermatol. 2006;  155 481
• 32 Neuvonen P J, Niemi M, Backman J T. Drug interactions with lipid-lowering drugs: mechanisms and clinical relevance.  Clin Pharmacol Ther. 2006;  80(6) 565-581
• 33 Tong J, Laport G, Lowsky R. Rhabdomyolysis after concomitant use of cyclosporine and simvastatin in a patient transplanted for multiple myeloma.  Bone Marrow Transplant. 2005;  36 739-740
• 34 Dourmishev L A, Stomonjakova S R, Dourmishev A L. D-penicillamine induced polymyositis and morphea in a woman with Hashimoto thyroiditis.  J Eur Acad Dermatol Venereol. 2002;  16 538-539
• 35 Magro C M, Schaefer J T, Waldman J, Knight D, Seilstad K, Hearne D. Terbinafine-induced dermatomyositis: a case report and literature review of drug-induced dermatomyositis.  J Cutan Pathol. 2008;  35 74-81
• 36 Dresser L P, Massey E W, Johnson E E, Bossen E. Ipecac myopathy and cardiomyopathy.  J Neurol Neurosurg Psychiatry. 1992;  55 560-562
• 37 Micromedex Healthcare Series .Finasteride. Thomson Healthcare Inc. Available at: http://www.thomsonhc.com/hcs/librarian/ND_T/HCS/ND_PR/Main/CS/CC3A4D Accessed November 15, 2008
• 38 Kanda F, Takatani K, Okuda S, Matsushita T, Chihara K. Preventive effects of insulinlike growth factor-I on steroid-induced muscle atrophy.  Muscle Nerve. 1999;  22 213-217
• 39 Batchelor T T, Taylor L P, Thaler H T, Posner J B, DeAngelis L M. Steroid myopathy in cancer patients.  Neurology. 1997;  48 1234-1238
• 40 Campellone J V, Lacomis D, Kramer D J, Van Cott A C, Giuliani M J. Acute myopathy after liver transplantation.  Neurology. 1998;  50 46-53
• 41 Hengstman G J, Vogels O J, ter Laak H J, de Witte T, van Engelen B G. Myositis during long-term interferon-alpha treatment.  Neurology. 2000;  54 2186-2189
• 42 Dietrich L L, Bridges A J, Albertini M R. Dermatomyositis after interferon alpha treatment.  Med Oncol. 2000;  17 64-69
• 43 Cirigliano G, Della Rossa A, Tavoni A, Viacava P, Bombardieri S. Polymyositis occurring during alpha-interferon treatment for malignant melanoma: a case report and review of the literature.  Rheumatol Int. 1999;  19 65-67
• 44 Matsuya M, Abe T, Tosaka M et al.. The first case of polymyositis associated with interferon therapy.  Intern Med. 1994;  33(12) 806-808
• 45 Lee S W, Kim K, Oh D et al.. A case of polymyositis with dilated cardiomyopathy associated with interferon alpha treatment for hepatitis B.  J Korean Med Sci. 2002;  17 141-143
• 46 Guttman-Yassky E, Hayek T, Muchnik L, Bergman R. Acute rhabdomyolysis and myoglobinuria associated with isotretinoin treatment.  Int J Dermatol. 2003;  42 499-500
• 47 Kaymak Y. Creatine phosphokinase values during isotretinoin treatment for acne.  Int J Dermatol. 2008;  47 398-401
• 48 Teicher A, Rosenthal T, Kissin E, Sarova I. Labetalol-induced toxic myopathy.  BMJ. 1981;  282 1824-1825
• 49 Gaist D, Rodríguez L A, Huerta C, Hallas J, Sindrup S H. Lipid-lowering drugs and risk of myopathy: a population-based follow-up study.  Epidemiology. 2001;  12 565-569
• 50 Fux R, Morike K, Gundel U, Hartmann R, Gleiter C H. Ezetimibe and statin-associated myopathy.  Ann Intern Med. 2004;  140 671-672
• 51 Link E, Parish S, Armitage J The SEARCH Collaborative Group et al.. SLCO1B1 variants and statin-induced myopathy—a genomewide study.  N Engl J Med. 2008;  359 789-799
• 52 Tsivgoulis G, Spengos K, Karandreas N, Panas M, Kladi A, Manta P. Presymptomatic neuromuscular disorders disclosed following statin treatment.  Arch Intern Med. 2006;  166 1519-1524
• 53 Baker S K, Tarnopolsky M A. Sporadic rippling muscle disease unmasked by simvastatin.  Muscle Nerve. 2006;  34 478-481
• 54 Staffa J A, Chang J, Green L. Cerivastatin and reports of fatal rhabdomyolysis.  N Engl J Med. 2002;  346 539-540
• 55 Needham M, Fabian V, Knezevic W, Panegyres P, Zilko P, Mastaglia F L. Progressive myopathy with up-regulation of MHC-I associated with statin therapy.  Neuromuscul Disord. 2007;  17 194-200
• 56 Vladutiu G D, Simmons Z, Isackson P J et al.. Genetic risk factors associated with lipid-lowering drug-induced myopathies.  Muscle Nerve. 2006;  34 153-162
• 57 Phillips P S, Haas R H, Bannykh S Scripps Mercy Clinical Research Center et al. Statin-associated myopathy with normal creatine kinase levels.  Ann Intern Med. 2002;  137 581-585
• 58 Agius M A, Zhu S, Fairclough R H. Antirapsyn antibodies in chronic procainamide-associated myopathy (CPAM).  Ann N Y Acad Sci. 1998;  841 527-529
• 59 Kam P CA, Cardone D. Propofol infusion syndrome.  Anaesthesia. 2007;  62 690-701
• 60 Nasu K, Sugano T, Yoshimatsu J, Narahara H. Rhabdomyolysis caused by tocolysis with oral ritodrine hydrochloride in a pregnant patient with myotonic dystrophy.  Gynecol Obstet Invest. 2006;  61(1) 53-55
• 61 Bayrakci U S, Baskin E, Ozcay F, Ozdemir B H, Karakayali H, Haberal M. Renal Fanconi syndrome and myopathy after liver transplantation: drug-related mitochondrial cytopathy?.  Pediatr Transplant. 2008;  12 109-112
• 62 Arnaudo E, Dalakas M, Shanske S, Moraes C T, DiMauro S, Schon E A. Depletion of muscle mitochondrial DNA in AIDS patients with zidovudine-induced myopathy.  Lancet. 1991;  337 508-510
• 63 Authier F J, Chariot P, Gherardi R K. Skeletal muscle involvement in human immunodeficiency virus (HIV)-infected patients in the era of highly active antiretroviral therapy (HAART).  Muscle Nerve. 2005;  32 247-260
• 64 Weber M, Diener H, Voit T, Neuen-Jacob E. Focal myopathy induced by chronic heroin injection is reversible.  Muscle Nerve. 2000;  23 274-277
• 65 Manlhiot C, Liang L, Tran D, Bitnun A, Tyrrell P N, Feldman B M. Assessment of an infectious disease history preceding juvenile dermatomyositis symptom onset.  Rheumatology. 2008;  47(4) 526-529
• 66 Schalinski S, Tsokos M. Fatal pyomyositis: a report of 8 autopsy cases.  Am J Forensic Med Pathol. 2008;  29(2) 131-135
• 67 Holmgren A R, Matteson E L. Lyme myositis.  Arthritis Rheum. 2006;  54(8) 2697-2700
• 68 Batra S, Naell A, Barwick C, Kanvinde R. Tuberculous pyomyositis of the thigh masquerading as malignancy with concomitant tuberculous flexor tenosynovitis and dactylitis of the hand.  Singapore Med J. 2007;  48(11) 1042-1046
• 69 Crum-Cianflone N, Mayer R. An unusual case of Lemierre's syndrome presenting as pyomyositis.  Am J Med Sci. 2008;  335(6) 499-501
• 70 Lin Y Y, Hsu C, Chu S, Chen S, Tsai S. Rapidly propagating descending necrotizing mediastinitis as a consequence of intravenous drug use.  Am J Med Sci. 2007;  334(6) 499-502
• 71 Atlas E, Novak S N, Duray P H, Steere A C. Lyme myositis: muscle invasion by Borrelia burgdorferi .  Ann Intern Med. 1988;  109(3) 245-246
• 72 Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M. Myositis during Borrelia burgdorferi infection (Lyme disease).  J Neurol Neurosurg Psychiatry. 1989;  52 1002-1005
• 73 Marfatia Y S, Ghiya R A, Chaudhary D. Dermatomyositis in a human immunodeficiency virus infected person.  Indian J Dermatol Venereol Leprol. 2008;  74(3) 241-243
• 74 Cupler E J, Leon-Monzon M, Miller J, Semino-Mora C, Anderson T L, Dalakas M C. Inclusion body myositis in HIV-1 and HTLV-1 infected patients.  Brain. 1996;  119 1887-1893
• 75 Dalakas M C, Rakocevic G, Shatunov A, Goldfarb L, Raju R, Salajegheh M. Inclusion body myositis with human immunodeficiency virus infection: four cases with clonal expansion of viral-specific T cells.  Ann Neurol. 2007;  61 466-475
• 76 Ozden S, Mouly V, Prevost M, Gessain A, Butler-Browne G, Ceccaldi P. Muscle wasting induced by HTLV-1 Tax-1 protein: an in vitro and in vivo study.  Am J Pathol. 2005;  167(6) 1609-1619
• 77 Friedman Y, Paul J T, Turley J, Hazrati L, Munoz D. Axial myopathy due to primary amyloidosis.  Muscle Nerve. 2007;  36 542-546
• 78 Chapin J E, Kornfeld M, Harris A. Amyloid myopathy: characteristic features of a still underdiagnosed disease.  Muscle Nerve. 2005;  31 266-272
• 79 Hadjivassiliou M, Chattopadhyay A K, Davies-Jones G A, Gibson A, Grünewald R A, Lobo A J. Neuromuscular disorder as a presenting feature of coeliac disease.  J Neurol Neurosurg Psychiatry. 1997;  63 770-775
• 80 Dayal N A, Isenberg D A. SLE/myositis overlap: are the manifestations of SLE different in overlap disease?.  Lupus. 2002;  11 293-298
• 81 Hall S, Hanrahan P. Muscle involvement in mixed connective tissue disease.  Rheum Dis Clin North Am. 2005;  31(3) 509-517
• 82 Le Roux K, Streichenberger N, Vial C et al.. Granulomatous myositis: a clinical study of thirteen cases.  Muscle Nerve. 2007;  35 171-177
• 83 Hill C L, Zhang Y, Sigurgeirsson B et al.. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study.  Lancet. 2001;  357 96-100
• 84 Toshikuni N, Torigoe R, Mitsunaga M, Omoto A, Nakashima K. Dermatomyositis associated with hepatocellular carcinoma in an elderly female patient with hepatitis C virus-related liver cirrhosis.  World J Gastroenterol. 2006;  12(10) 1641-1644
• 85 Levin M I, Mazaffar T, Taher Al-Lozi M, Pestronk A. Paraneoplastic necrotizing myopathy: clinical and pathologic features.  Neurology. 1998;  50(3) 764-767
• 86 Sampson J B, Smith S M, Smith A G et al.. Paraneoplastic myopathy: response to intravenous immunoglobulin.  Neuromuscul Disord. 2007;  17 404-408