![]() Patients with myositis present with muscle weakness and atrophy in the proximal muscles and increases in serum levels of muscular enzymes. Idiopathic inflammatory myopathies, collectively termed myositis, are autoimmune diseases characterized by skeletal muscle inflammation. It has been reported that muscle strength in patients treated with > 40 mg/day of prednisone was significantly less than that in patients treated with < 40 mg/day. ![]() It is known that steroid myopathy occurs in a dose-related manner. Muscle weakness in steroid myopathy usually begins in the proximal portion of the lower extremities, progresses to the upper proximal extremities, and finally affects the distal extremities. Steroid myopathy is another side effect of steroid therapy, which is induced by the catabolic action of steroids on skeletal muscles. Although steroid therapy is useful, there are various side effects, such as an associated increased susceptibility to infection or glucose intolerance. Steroid therapy is a crucial form of treatment for inflammatory, allergic, and immunological disorders and has been used for > 50 years. Our study suggests the importance of therapies that not only improve muscle mass but also improve the quality of muscle strength. In patients with myositis treated with steroid therapy, muscle mass decreased after steroid therapy suggesting that the improvement in muscle strength was due to factors other than a change in muscle volume. In the myositis group, patients with chronic obstructive pulmonary disease showed a tendency toward muscle volume loss ( p = 0.0571). In both groups, the cross-sectional areas of skeletal muscles decreased (myositis group: p = 0.0156 control group: p = 0.0391) and the low muscle attenuation rate tended to increase (myositis group: p = 0.0781 control group: p = 0.0547). Muscular strength and serum muscle enzyme levels improved following steroid therapy in patients with myositis. Statistical significance was set at p < 0.05. The Spearman’s rank correlation coefficient was used for determining the correlations between two variables. The Mann-Whitney U test was used to compare sets of data sampled from two groups. ![]() The Wilcoxon signed-rank test was used for comparing paired data for each patient. ![]() Data were subjected to statistical analysis using several well-established statistical tests. The cross-sectional area of skeletal muscle and the low muscle attenuation rate at the level of the caudal end of the third lumbar vertebra were obtained using CT and measured using an image analysis program for all patients. Clinical factors in patients with myositis included serum muscle enzyme levels and muscular strength. Methodsĭata from seven patients with myositis and eight controls, who were all treated with high doses of steroids, were assessed before and after steroid therapy. We aimed to determine the change in muscle mass after steroid therapy via cross-sectional computed tomography (CT) in patients with myositis. Thus, it is currently unclear whether steroid therapy for such patients affects muscle volume in addition to muscle strength. Steroid therapy is considered the first-line therapy for myositis however, there have been no reports strictly comparing the muscle mass in patients with myositis before and after steroid therapy. Steroid therapy, a key therapy for inflammatory, allergic, and immunological disorders, is often associated with steroid myopathy as one of the side effects.
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