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Myopathic changes associated with severe acute respiratory syndrome: a postmortem case series.
Arch Neurol. 2005 Jul; 62(7):1113-7.AN

Abstract

BACKGROUND

The March 2003 outbreak of the severe acute respiratory syndrome (SARS) resulted in significant morbidity and mortality. Muscle weakness and elevated serum creatine kinase levels are commonly encountered in patients with SARS. However, the nature and cause of myopathy associated with a SARS infection are unknown because, to our knowledge, there has been no report of histological or postmortem examination of the skeletal muscle from SARS-infected patients.

OBJECTIVE

To determine the exact nature of the myopathy associated with SARS.

METHOD

Postmortem skeletal muscles from 8 consecutive patients who died of SARS in March 2003 were studied under light and electron microscopy as well as immunohistochemistry.

RESULTS

Focal myofiber necrosis was identified in 4 of 8 cases. Macrophage infiltration and regenerative fiber were scanty. All 4 patients treated with a steroid had significant myofiber atrophy. In situ hybridization for coronavirus was negative in all subjects. Viral cultures for coronavirus and examination for viral particles under electron microscopy were performed in 2 patients. The viral culture yielded no organisms and there were no viral particles seen on electron microscopic examination.

CONCLUSIONS

There is a spectrum of myopathic changes associated with a SARS infection. Focal myofiber necrosis is common and possibly is immune mediated. Critical illness myopathy and superimposed steroid myopathy may also play an important role in SARS.

Authors+Show Affiliations

Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong. drtleung@cuhk.edu.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16009768

Citation

Leung, Thomas W., et al. "Myopathic Changes Associated With Severe Acute Respiratory Syndrome: a Postmortem Case Series." Archives of Neurology, vol. 62, no. 7, 2005, pp. 1113-7.
Leung TW, Wong KS, Hui AC, et al. Myopathic changes associated with severe acute respiratory syndrome: a postmortem case series. Arch Neurol. 2005;62(7):1113-7.
Leung, T. W., Wong, K. S., Hui, A. C., To, K. F., Lai, S. T., Ng, W. F., & Ng, H. K. (2005). Myopathic changes associated with severe acute respiratory syndrome: a postmortem case series. Archives of Neurology, 62(7), 1113-7.
Leung TW, et al. Myopathic Changes Associated With Severe Acute Respiratory Syndrome: a Postmortem Case Series. Arch Neurol. 2005;62(7):1113-7. PubMed PMID: 16009768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Myopathic changes associated with severe acute respiratory syndrome: a postmortem case series. AU - Leung,Thomas W, AU - Wong,Ka Sing, AU - Hui,Andrew C, AU - To,Ka Fai, AU - Lai,Sik To, AU - Ng,Wai Fu, AU - Ng,Ho Keung, PY - 2005/7/13/pubmed PY - 2005/8/3/medline PY - 2005/7/13/entrez SP - 1113 EP - 7 JF - Archives of neurology JO - Arch Neurol VL - 62 IS - 7 N2 - BACKGROUND: The March 2003 outbreak of the severe acute respiratory syndrome (SARS) resulted in significant morbidity and mortality. Muscle weakness and elevated serum creatine kinase levels are commonly encountered in patients with SARS. However, the nature and cause of myopathy associated with a SARS infection are unknown because, to our knowledge, there has been no report of histological or postmortem examination of the skeletal muscle from SARS-infected patients. OBJECTIVE: To determine the exact nature of the myopathy associated with SARS. METHOD: Postmortem skeletal muscles from 8 consecutive patients who died of SARS in March 2003 were studied under light and electron microscopy as well as immunohistochemistry. RESULTS: Focal myofiber necrosis was identified in 4 of 8 cases. Macrophage infiltration and regenerative fiber were scanty. All 4 patients treated with a steroid had significant myofiber atrophy. In situ hybridization for coronavirus was negative in all subjects. Viral cultures for coronavirus and examination for viral particles under electron microscopy were performed in 2 patients. The viral culture yielded no organisms and there were no viral particles seen on electron microscopic examination. CONCLUSIONS: There is a spectrum of myopathic changes associated with a SARS infection. Focal myofiber necrosis is common and possibly is immune mediated. Critical illness myopathy and superimposed steroid myopathy may also play an important role in SARS. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/16009768/Myopathic_changes_associated_with_severe_acute_respiratory_syndrome:_a_postmortem_case_series_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.62.7.1113 DB - PRIME DP - Unbound Medicine ER -