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October 1967

Effect of Cortisone on the Structure and Strength of Skeletal Muscle: A Correlative Electron Microscopic and Isometric Tension Study

Author Affiliations

St. Louis
From the Department of Anatomy and the Division of Orthopedic Surgery, Washington University School of Medicine, St. Louis. Dr. Ritter is a trainee in orthopedic surgery (Institute of Arthritis and Metabolic Diseases, Tl-AM 5311-02).

Arch Neurol. 1967;17(4):403-413. doi:10.1001/archneur.1967.00470280069007

MUSCLE weakness, a prominent feature in Cushing's syndrome whether primary or secondary, was described in roughly half of Cushing's original cases.1 Müllen2 also described proximal muscle weakness in six patients with Cushing's syndrome; in several it was an early symptom. More recently, a myopathy has been observed in some patients on prolonged adrenocortical therapy. Perkoff3 reported seven patients who developed weakness, especially of proximal leg muscles, during steroid therapy of blood dyscrasias. Byers4 noted myopathy in five out of 250 children on steroids for rheumatic fever. Steroids given for polyarteritis, asthma, scleroderma, lupus erythematosus, rheumatoid arthritis, and as replacement therapy following hypophysectomy also have resulted in myopathy.5-9 It has been thought that the weakness was not due to the basic disease. Serum potassium levels were normal. The incidence of this complication is said to be greater with fluorinated steroids. Ellis10 and Glaser11

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