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Short-term Effects of Corticosteroid Therapy on Cardiac and Skeletal Muscles in Muscular Dystrophies
  1. Gehan Hussein, MD*,
  2. Lobna Mansour, MD,
  3. Hadeer Abdel Ghafar, MD,
  4. Fatma Alzahraa Mostafa, MD*,
  5. Lubna Fawaz, MD
  1. From the Departments of *Pediatric Cardiology, and †Pediatric Neurology, Faculty of Medicine, Cairo University, Cairo; ‡Department of Pediatric Neurology, Faculty of Medicine, Fayoum University, Giza, Egypt.
  1. Received January 19, 2013, and in revised form March 21, 2014.
  2. Accepted for publication March 24, 2014.
  3. Reprints: Gehan Hussein, MD, Zahraa El Maadi, Tiba, number 8, flat 107, First Floor, Cairo, Egypt. E-mail: gehanha{at}hotmail.com.
  4. The authors did not receive funds from any organization to do this work.

Abstract

Background Duchenne muscular dystrophy (DMD) is the most common muscular dystrophy of childhood. It leads to progressive deterioration in cardiac and skeletal muscles. Corticosteroids are considered an effective therapy.

Objective This study aimed to evaluate the role of short-term prednisone therapy in improving left ventricular (LV) systolic function, LV mass (LVM), and motor power in cases of muscular dystrophies.

Patients and Methods Twenty-five cases of muscular dystrophy including 17 cases of DMD, 3 cases of Becker muscular dystrophies, and 5 cases of female patients with DMD-like phenotype were included in the study. The diagnosis of 12 patients was confirmed by muscle biopsy with immunohistochemistry; the patients were subjected to motor assessment, measurement of creatine kinase level, and echocardiographic examination before and after prednisone therapy. Transthoracic echocardiographic assessment of the LV systolic function (fractional shortening) was done. Myocardial performance index and LVM were calculated. Intermittent dosage of prednisone was administered 5 mg/kg per day on 2 consecutive days weekly for 3 months.

Results Fractional shortening improved on prednisone therapy (P = 0.009) and LVM increased (P = 0.012); improvement in walking was detected in 77% of the patients, climbing stairs improved in 88.9%, Gower sign improved in 70%, and rising from chair improved in 60%. Prednisone had no effect on the patients with marked motor impairment (on wheelchair). The creatine kinase level was significantly lower after steroid therapy (P = 0.04).

Conclusions Three months of intermittent prednisone therapy could improve cardiac and skeletal muscle function in congenital muscular dystrophy.

Key Words
  • muscular dystrophy
  • prednisone
  • left ventricular systolic function
  • myocardial performance index
  • left ventricular mass
  • creatine kinase

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