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Steroid Myopathy

  : : I am suffering with Steriod Myopathy.  My upper legs are affected and very weak.  Standing up from chairs, climbing stairs and going up over curbs is very difficult.  My back muscles also seem affected -- for example, I cannot do sit-ups at all.
  : : I was on Decadron IV 12 mgs/day for 3 weeks, then switched to oral Decadron, 12 mgs/day for an additional 2 1/2 months.  The dosage has been dropped to 8 mgs/day (about 8 weeks ago) then to 4 mgs/day (about 4 weeks ago).  The current dose is 4 mgs/day.  Diagnosis is probable CNS Vasculitis.
  : : My question:  How long does it take for this weakness to go away?   At what dosage does it normally disappear.  I recognize some (or possibly) all of the sypmtoms may be active vasculitis, but the rhuematologist does not think so.  Also, it has gotten better as the sterioids have been reduced.
  : : Is there anything (exercises?) that I can do to improve the situation?
  : : Thank you.
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  : Thanks for the question. The answer is that there is not magic dose that causes steroid myopathy and not set time that the symptoms will go away. In general if patients can get to everyother day dosing on their steroids then they have fewer side effects. The other option is to add a second medication to spare the steroids such as imuran or one of the other immunosuppresant medication. An EMG (electromyography ) test can be used to actually diagnos the myopathy if needed. You should see some improvement in strength as the steroid dose is dropped. but it will be slow. No specific exercise is helpful and we generally recommend patients not overexerting themselves but it is important to do some exercise so that you do not become to deconditioned. Good luck
  : This information is provided for general medical education purposes. Please consult your doctor regarding diagnostic and treatment options.
Thanks for the additional information. At our institution these types pf problems are mostly handled by the rheumatologists. The classic treatment is steroids and cytoxan. If these can not be treated then it is depend somewhat on the experience and belief of the rheumatologist as to which medication is given next. I think at CCF they usually go to methotrexate next. If that is not helpful maybe cyclosporin or imuran but as you can imagine these are less effective. Hope the additional information helps.
This information is provided for general medical education purposes only. Please consult your doctor regarding diagnostic and treatment options.

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