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- W2089522016 abstract "Letters15 August 1993Respiratory Failure from Procainamide-induced MyopathyRajeev V. Venkayya, R. Michael Poole, and William H. PentzRajeev V. VenkayyaSearch for more papers by this author, R. Michael PooleSearch for more papers by this author, and William H. PentzSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-4-199308150-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Procainamide can cause respiratory failure [1-3] that has been attributed to diaphragmatic weakness from impaired neuromuscular junction transmission; in previously reported cases, all but one patient had preexisting myasthenia gravis [3]. We report a patient who, while taking procainamide, developed respiratory failure caused by necrotizing myopathy with diaphragm involvement. Electrodiagnostic evaluation showed no neuromuscular junction abnormality.A 74-year-old man developed supraventricular arrhythmias after coronary artery bypass grafting and was treated with procainamide. Two weeks later arm weakness and back and shoulder pain developed. Physical examination showed muscle tenderness and symmetric proximal weakness. Reflexes and sensation were normal. ...References1. Drachman DA, Skom JH. Procainamidea hazard in myasthenia gravis. Arch Neurol. 1965; 13:316-20. Google Scholar2. Godley PJ, Morton TA, Karboski JA, Tami JA. Procainamide-induced myasthenic crisis. Ther Drug Monit. 1990; 12:411-4. Google Scholar3. Javaheri S, Logemann TN, Corser BC, Guerra LF, Means E. Diaphragmatic paralysis. Am J Med. 1989; 86:623-4. Google Scholar4. Fontiveros ES, Cumming WJ, Hudgson P. Procainamide-induced myositis. J Neurol Sci. 1980; 45:143-7. Google Scholar5. Lewis CA, Boheimer N, Rose P, Jackson G. Myopathy after short term administration of procainamide. Br Med J (Clin Res Ed). 1986; 292:593-4. Google Scholar Author, Article, and Disclosure InformationAuthors: Rajeev V. Venkayya; R. Michael Poole; William H. Pentz PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byToxic MyopathiesNeurological complications of cardiovascular drugsProcainamideNeurologic complications of arrhythmia treatmentANTIDYSRHYTHMIC DRUGSProcainamideElectromyography of the diaphragm in neuromuscular diseasePositive inotropic drugs and drugs used in dysrhythmiasProcainamide 15 August 1993Volume 119, Issue 4Page: 345-346KeywordsAntinuclear antibodiesBiopsyCreatine kinaseElectromyographyMuscle biopsiesMusclesNervesReflexesRespiratory failureUrine ePublished: 15 August 2000 Issue Published: 15 August 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ..." @default.
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