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
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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Case Report
Ublituximab Treatment for Multiple Sclerosis and Rheumatoid Arthritis in a Patient with Insulin Dependent Diabetes: A Case Report
Issue:
Volume 10, Issue 1, March 2026
Pages:
15-19
Received:
7 February 2026
Accepted:
21 February 2026
Published:
4 March 2026
DOI:
10.11648/j.cnn.20261001.13
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Abstract: The introduction of monoclonal antibodies has radically changed the field of neuroimmunology and specifically for multiple sclerosis, the monoclonal antibodies targeting B-cells have proven to be very effective therapeutic agents. However, the not uncommon scenario of the co-existence of more than one autoimmune disorder in single patients poses the challenge of attempting to minimize the risks of complications brought on by overlapping multiple immune therapies. The preferable option would be to use one treatment that would combine efficacy across the different diseases. Because randomized clinical trials testing new treatments are not typically designed to investigate effects on patients with two or more immune diseases, case reports provide some evidence-based medicine for clinicians. Here we describe a remarkable clinical improvement observed with two administrations of ublituximab in a 45 year-old male who had juvenile onset of insulin dependent diabetes and had been diagnosed with multiple sclerosis more than ten years earlier. Besides a short course of steroids at the time of diagnosis, the patient had not received any prior disease modifying therapy for multiple sclerosis, and at the time of presentation at our center, he manifested signs and symptoms that led to the new diagnosis of rheumatoid arthritis. With details on the clinical features and laboratory results, this case illustrates the unprecedented attempt to treat the combination of multiple sclerosis and rheumatoid arthritis with ublituximab. An early treatment with a disease modifying therapy capable of a radical impact on the inflammatory activity underlying both multiple sclerosis and rheumatoid arthritis could be viewed as a probable factor for a favorable outcome.
Abstract: The introduction of monoclonal antibodies has radically changed the field of neuroimmunology and specifically for multiple sclerosis, the monoclonal antibodies targeting B-cells have proven to be very effective therapeutic agents. However, the not uncommon scenario of the co-existence of more than one autoimmune disorder in single patients poses th...
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