High dose steroid therapy complications

The mean age of the patients at the start of the INF was years (range 2–20 years). At the initiation of INF, 62% (21/34) of patients were ≥10 years of age. The mean duration of uveitis prior to INF treatment was years (2–8 years). The mean duration of steroid treatment prior to start of disease modifying antirheumatic drugs (DMARD) therapy was 2 years (– years). Prior to INF therapy, all patients had been treated with steroids. This included 15/34 (44%) patients that received topical steroids and 19/34 (56%) patients that were on both topical and systemic steroids. The average dose of systemic steroid was  mg/kg, and the maximum dose was 20 mg per day for a mean period of months. Topical prednisone administration varied significantly from every hour while awake to once a day. Based on the dosage given, there were 6 (18%) patients assigned to the LD group, 19 (56%) patients to the MD group, and 9 (26%) patients to the HD group. Dosing was determined by the primary pediatric rheumatologist on the basis of disease duration, disease activity at the time of presentation, and prior medication failures.

mg/day inhaled via jet nebulizer either once daily or divided into 2 doses. The maximum manufacturer recommended total dose is 1 mg/day. The National Asthma Education and Prevention Program Expert Panel defines low dose therapy for budesonide inhalation suspension as mg/day, medium dose therapy as 1 mg/day, and high dose therapy as 2 mg/day for children ages 5 to 11 years. Titrate to the lowest effective dose once asthma stability is achieved. Prolonged use of high doses, ., 2 mg/day, may be associated with additional adverse effects.

30 mg/kg/dose (Max: 1 gram/dose) IV or IM once daily for 1 to 3 days. High-dose pulse steroids may be considered as an alternative to a second infusion of IVIG or for retreatment of patients who have had recurrent or recrudescent fever after additional IVIG, but should not be used as routine primary therapy with IVIG in patients with Kawasaki disease. Corticosteroid treatment has been shown to shorten the duration of fever in patients with IVIG-refractory Kawasaki disease or patients at high risk for IVIG-refractory disease. A reduction in the frequency and severity of coronary artery lesions has also been reported with pulse dose methylprednisolone treatment.

High dose steroid therapy complications

high dose steroid therapy complications


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