Acute hydrocortisone myopathy in acute severe asthma.

Myopathy of insidious onset produced by corticosteroids is well recognised. In recent years acute myopathy has been reported in patients with acute severe asthma treated with 3-4 g of intravenous hydrocortisone a day.1 2 It has been argued that to minimise the risks of this the dose should be no more than 1 g of hydrocortisone a day.2 There is evidence that 1 g/day is an effective regimen.3 We report a further case of acute myopathy occurring in a patient who never received more than 1 g/day of intravenous hydrocortisone. We suggest that even with a 1 g/day regimen physicians should be aware of the possibility of myopathy developing if a patient is found to be slow to be weaned off ventilation.