Case Report
Corticosteroid-Induced Myopathy in a 10-Year-Old: A Case from Kara (Togo)
Lehleng Agba*
,
Kokou Mensah Guinhouya,
Komla Nyinèvi Anayo,
Adama Ephoevi-Ga,
Komi Apetse,
Vinyo Kumako,
Damelan Kombaté,
Komi Assogba,
Mofou Belo,
Agnon Ayelola Balogou
Issue:
Volume 10, Issue 1, March 2026
Pages:
1-4
Received:
1 October 2025
Accepted:
7 January 2026
Published:
16 January 2026
Abstract: Introduction: Corticosteroid-induced myopathy (CIM) remains underdiagnosed, particularly in children. Its acute form can emerge rapidly after the initiation of corticosteroid therapy, sometimes within the first few days. Identification relies on a constellation of clinical-chronological and biological arguments, together with observation of the course after steroid withdrawal. We report an acute CIM in a 10-year-old girl from Kara (Togo) to illustrate a pragmatic diagnostic approach in a resource-limited setting. Case presentation: A 10-year-old schoolgirl referred for right-sided visual loss received an initial corticosteroid course with methylprednisolone 240 mg/day for 5 days, with partial improvement. Two weeks later, following a relapse, she received a second course of methylprednisolone 1 g/day for 5 days. Four days after completing this treatment, she developed diffuse myalgias and proximal weakness with inability to raise the lower limbs and walk. Beyond the clinical picture, laboratory tests showed creatine kinase (CK) 876 U/L (≈7.6× the upper limit of normal [ULN]) and aspartate aminotransferase (AST) ≈2.5× ULN, supporting a diagnosis of CIM. Other muscle enzymes were unavailable, as was electromyography. Management consisted of steroid withdrawal, analgesics and anti-inflammatory agents, and physiotherapy. Clinical improvement occurred within 72 hours; on day 7, CK was 430 U/L (≈3.7× ULN), followed by normalization to 97 U/L at 3 months, with complete functional recovery. Conclusion: This observation illustrates that early-onset proximal weakness occurring soon after corticosteroid pulses should prompt consideration of CIM, even in the absence of EMG. In resource-limited contexts, the trajectory of CK and the response to dechallenge are decisive elements that help optimize prognosis in a timely manner.
Abstract: Introduction: Corticosteroid-induced myopathy (CIM) remains underdiagnosed, particularly in children. Its acute form can emerge rapidly after the initiation of corticosteroid therapy, sometimes within the first few days. Identification relies on a constellation of clinical-chronological and biological arguments, together with observation of the cou...
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Research Article
Management and Progression of Guillain-Barre Syndrome in a Resource-limited Setting: A Multicenter Study in the University Hospitals of Ouagadougou, Burkina Faso
Issue:
Volume 10, Issue 1, March 2026
Pages:
5-14
Received:
2 February 2026
Accepted:
11 February 2026
Published:
25 February 2026
DOI:
10.11648/j.cnn.20261001.12
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Abstract: Introduction: Guillain-Barre syndrome (GBS) faces many diagnostic and therapeutic challenges in sub-Saharan Africa, negatively impacting patient prognosis. The aim of this study was to describe the therapeutic and evolutionary modalities of GBS in the university hospitals of Ouagadougou, Burkina Faso. Patients and methods: This was a descriptive cross-sectional study with prospective data collection, conducted in the university hospitals of Ouagadougou (Yalgado Ouedraogo, Tengandogo, Bogodogo) from March 2018 to May 2022. Patients aged ˃ 16 years admitted for GBS according to the modified Brighton criteria were included. Clinical severity at the time of admission and at the end of hospitalization was assessed using the GBS Disability Score (GBSDS). Socio-demographic, clinical, therapeutic, and in-hospital progression data were analyzed. Results: A total of 79 patients were consecutively hospitalized for GBS, with a mean age of 38 years and a male-to-female ratio of 1.25. The mean time to admission was 22 days. The clinical picture consisted of hypo- or areflexic tetraparesis/plegia (100%) with respiratory muscle deficit (44.3%), cranial nerve involvement (58.2%), dysautonomia (55.7%), and albumin-cytological dissociation (100%). ENMG showed demyelinating and axonal forms in 57.6% and 42.4% of cases, respectively. At the plateau phase, 36% and 21% of patients had very severe deficits (Guillain-Barre Syndrome Disability Score (GBSDS 4)) and respiratory distress (GBSDS 5), respectively. Corticosteroid therapy (58.2%) and intravenous immunoglobulins (IVIg) (6.8%) were the specific therapies used. Infectious complications (41.8%), particularly inhalation pneumonia (27.8%), acute respiratory distress (13.9%), and cardiac dysautonomia complications (6.3%), were the most common hospital complications. Eighteen patients (22.8%) were transferred to intensive care, mainly due to the onset of respiratory distress (13.9%). At the end of hospitalization, the hospital mortality rate was 22.8%, with acute respiratory distress (44.4%) and dysautonomic cardiac arrest (16.7%) being the most common immediate causes of death. Conclusion: In Burkina Faso, GBS is confronted with delays in patient admission, low availability and access to IVIG and EP, and high hospital mortality. Early admission and improved access to emergency immunotherapy and intensive care beds in ASS will help improve the prognosis for patients with GBS.
Abstract: Introduction: Guillain-Barre syndrome (GBS) faces many diagnostic and therapeutic challenges in sub-Saharan Africa, negatively impacting patient prognosis. The aim of this study was to describe the therapeutic and evolutionary modalities of GBS in the university hospitals of Ouagadougou, Burkina Faso. Patients and methods: This was a descriptive cr...
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