A 55-year-old woman with severe asthma on high-dose prednisone (60 mg daily) for 6 months presents with progressive difficulty rising from chairs and climbing stairs. Vital signs: BP 138/82, HR 92, RR 16, Temp 98.6°F, SpO2 98%. Examination reveals symmetric proximal lower extremity weakness without pain or tenderness. Serum creatine kinase is 95 U/L. EMG shows no myopathic changes. Which diagnosis best explains her presentation?
- A)Guillain-Barré syndrome
- B)Glucocorticoid induced myopathyGABARITO
- C)Lambert-Eaton syndrome
- D)Polymyositis
- E)Dermatomyositis
Explicação
Chronic glucocorticoid exposure can cause a painless proximal myopathy, typically with normal CK and type II muscle fiber atrophy. The clinical clue is progressive proximal weakness developing during prolonged steroid therapy. Ver explicação completa e trilha adaptativa →