PubMed · 4979406
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L Szántó. 1969-04-01. [Secondary subacute thyroiditis].. https://pubmed.ncbi.nlm.nih.gov/4979406/
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Steroid myopathy is one of the various side effects of prolonged treatments, particularly with the 9 alpha fluorinated steroids. The receptor protein probably plays a major role with a decrease in protein synthesis. There is no mean to detect this myopathy before clinical signs appear. Neither muscular testing nor enzymes nor electromyography give arguments and muscular biopsy is aggressive. Low density scanner and MNR could help diagnosis. Frequency of disease is not known. A total cumulative maintenance steroid dosage of 400 mg can be sufficient. Proximal muscles are usually involved, quadriceps and other pelvic girdle muscles being more severely affected. Fast twitch glycolytic type IIB fibers are particularly susceptible. Physical exercise is effective in preventing myopathy. Nevertheless, no special rehabilitation program has been tested for the moment in human beings.
Endogenous glucocorticoid excess with concomitant hypercortisolaemia and increased saliva levels of the free active hormone, is a common feature of HIV-infected/AIDS patients. Exposure of the oral tissues to virtually uninterrupted high burden of glucocorticoids through saliva may contribute to the high frequency of oral Kaposi's sarcoma (KS) in these patients. AIDS-KS cells contain unusually high levels of glucocorticoid receptor protein and recent studies indicate that growth of these cells in culture is significantly stimulated by glucocorticoids, particularly in the presence of growth factors, such as oncostatin-M. The suggestion that glucocorticoid excess may be important in the pathogenesis of KS in AIDS is not in conflict with the suspected aetiological role of newly reported KS-associated herpesviruses (KSHV), since steroid hormones may upregulate the expression of the viral gene. The latter is consistent with the observation that infection by specific oncogenic viruses does not necessarily result in cancers in the human, and does require the presence of other cellular factors or events.
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