Abstract
Myoglobinuria is a recognised complication of Duchenne muscular dystrophy (DMD), but has only once been reported in ambulant boys on corticosteroid therapy [Dubowitz V, Kinali M, Main M, Mercuri E, Muntoni F. Remission of clinical signs in early Duchenne muscular dystrophy on intermittent low-dosage prednisolone therapy. Eur J Paediatr Neurol 2002;6(3):153-9.]. We present three prednisolone-treated boys with myoglobinuria and in two cases this was recurrent. All three showed improved motor performance in response to the introduction of corticosteroids. The greater activity of steroid-treated individuals may place their dystrophin-deficient muscles under greater mechanical stress, predisposing to further muscle fibre damage and consequent myoglobinuria. Families and physicians need to have an increased awareness of this possibility and of the appropriate management of myoglobinuria.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adrenal Cortex Hormones / adverse effects*
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Child
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Exercise Therapy / adverse effects*
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Humans
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Male
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Motor Activity / physiology
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Movement / physiology
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Muscle Fibers, Skeletal / metabolism
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Muscle Fibers, Skeletal / pathology
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Muscle, Skeletal / drug effects*
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Muscle, Skeletal / pathology
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Muscle, Skeletal / physiopathology
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Muscular Dystrophy, Duchenne / complications*
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Muscular Dystrophy, Duchenne / drug therapy*
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Muscular Dystrophy, Duchenne / physiopathology
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Myoglobin / metabolism
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Myoglobinuria / chemically induced*
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Myoglobinuria / pathology
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Myoglobinuria / physiopathology
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Prednisolone / adverse effects
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Rhabdomyolysis / chemically induced
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Rhabdomyolysis / pathology
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Rhabdomyolysis / physiopathology
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Stress, Mechanical
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Treatment Outcome
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Withholding Treatment
Substances
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Adrenal Cortex Hormones
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Myoglobin
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Prednisolone