Aktueller Stand bei toxischen Myopathien

Zusammenfassung

Eine zunehmende Anzahl von Medikamenten und Toxinen kann zu funktionellen und strukturellen Veränderungen der Skelettmuskulatur führen. Das klinische Bild reicht von einer asymptomatischen CK-Erhöhung über Muskelschmerzen und -paresen bis zur potenziell tödlichen Rhabdomyolyse. Das frühe Erkennen dieser Myopathien ist für den Krankheitsverlauf entscheidend, da sie nach Absetzen des auslösenden Agens meist reversibel sind. Ihre pathophysiologischen Hintergründe sind vielfach noch ungeklärt. Die häufigste Toxin-induzierte Myopathie ist die Alkoholmyopathie. Unter den medikamentös-induzierten Myopathien finden vor allem die Lipidsenker-, daneben auch die Steroidmyopathien Beachtung. Zunehmend an Bedeutung haben die in der antiretroviralen HIV-Therapie eingesetzten Substanzen in den letzten Jahren gewonnen.

Summary

A growing number of drugs and toxins can cause functional and structural damage to human skeletal muscle. These myopathies may manifest themselves as an asymptomatic creatinin kinase elevation, muscle pain or weakness and even acute rhabdomyolysis. Early diagnosis is important, because these myopathies are potentially reversible on removal of the offending agent. The precise mechanisms remain mostly unclear. Main source ofa toxic myopathy is chronic alcohol abuse. Drug-induced myopathies are most frequently seen due to lipid lowering agents and corticosteroids. Since introduction of specific HIV-therapy antiretroviral substances gain importance as another trigger for myopathy.

Schlüsselwörter

Myopathie - Mechanismen - Alkohol - Kortikosteroide - Lipidsenker - antiretrovirale Therapie

Keywords

Myopathy - mechanisms - alcohol - corticosteroids - lipid lowering agents - antiretroviral therapy

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