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January 1, 1998

Acute myopathy after liver transplantation

January 1998 issue
50 (1) 46-53

Abstract

Acute myopathy is a cause of weakness and additional morbidity in a variety of critically ill patients, including transplant recipients. We report the incidence of and risk factors associated with acute myopathy after orthotopic liver transplantation (OLTx). One hundred consecutive adult patients were prospectively assessed for muscle weakness after OLTx. Electrodiagnostic studies and muscle biopsies were performed on consenting affected patients. Potential risk factors for myopathy were evaluated in patients with myopathy versus control subjects. Seven patients developed acute persistent weakness after OLTx. Electrodiagnostic studies were consistent with a necrotizing myopathy. Histopathologic evaluation in five revealed a necrotizing myopathy with loss of myosin thick filaments. A higher initial index of illness severity, dialysis requirement, and higher doses of glucocorticoids were associated with development of myopathy. Patients with myopathy subsequently remained in the intensive care unit (ICU) longer than unaffected patients. In conclusion, acute substantial weakness was a source of additional morbidity in 7% of patients after OLTx. Most had myopathy with loss of myosin thick filaments. Patients with greater severity of illnesses and renal failure requiring dialysis were more likely to be affected. The effect of reducing exposure to corticosteroids in high-risk patients warrants further investigation.

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Information & Authors

Information

Published In

Neurology®
Volume 50Number 1January 1998
Pages: 46-53
PubMed: 9443456

Publication History

Published online: January 1, 1998
Published in print: January 1998

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Authors

Affiliations & Disclosures

J. V. Campellone, MD
From the Departments of Neurology (Drs. Campellone, Lacomis, Van Cott, and Giuliani), Pathology, Division of Neuropathology (Dr. Lacomis), and Anesthesiology and Critical Care Medicine (Dr. Kramer), The University of Pittsburgh Medical Center, Pittsburgh, PA.
D. Lacomis, MD
From the Departments of Neurology (Drs. Campellone, Lacomis, Van Cott, and Giuliani), Pathology, Division of Neuropathology (Dr. Lacomis), and Anesthesiology and Critical Care Medicine (Dr. Kramer), The University of Pittsburgh Medical Center, Pittsburgh, PA.
D. J. Kramer, MD
From the Departments of Neurology (Drs. Campellone, Lacomis, Van Cott, and Giuliani), Pathology, Division of Neuropathology (Dr. Lacomis), and Anesthesiology and Critical Care Medicine (Dr. Kramer), The University of Pittsburgh Medical Center, Pittsburgh, PA.
A. C. Van Cott, MD
From the Departments of Neurology (Drs. Campellone, Lacomis, Van Cott, and Giuliani), Pathology, Division of Neuropathology (Dr. Lacomis), and Anesthesiology and Critical Care Medicine (Dr. Kramer), The University of Pittsburgh Medical Center, Pittsburgh, PA.
M. J. Giuliani, MD
From the Departments of Neurology (Drs. Campellone, Lacomis, Van Cott, and Giuliani), Pathology, Division of Neuropathology (Dr. Lacomis), and Anesthesiology and Critical Care Medicine (Dr. Kramer), The University of Pittsburgh Medical Center, Pittsburgh, PA.

Notes

Address correspondence and reprint requests to Dr. Joseph V. Campellone, Department of Neurology, Cooper Hospital/University Medical Center, 3 Cooper Plaza, Suite 320, Camden, NJ 08103.

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  1. Exacerbation of Myopathy in Glycogen Debrancher Deficiency After Liver Transplantation: Case Report and Review of the Literature, Transplantation Proceedings, 56, 5, (1153-1156), (2024).https://doi.org/10.1016/j.transproceed.2024.02.020
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  3. Critical illness–associated weakness and related motor disorders, Motor System Disorders, Part I: Normal Physiology and Function and Neuromuscular Disorders, (707-777), (2023).https://doi.org/10.1016/B978-0-323-98818-6.00031-5
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  8. Intensive Care Unit-acquired Neuromuscular Weakness: A Prospective Study on Incidence, Clinical Course, and Outcomes, Indian Journal of Critical Care Medicine, 25, 9, (1006-1012), (2021).https://doi.org/10.5005/jp-journals-10071-23975
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  9. Critical illness neuromyopathy, Annals of Clinical Neurophysiology, 22, 2, (61-66), (2020).https://doi.org/10.14253/acn.2020.22.2.61
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  10. Intensive Care Unit-Acquired Weakness: Neuropathology, Journal of Clinical Neurophysiology, 37, 3, (197-199), (2020).https://doi.org/10.1097/WNP.0000000000000660
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