TITLE:
Does Low-Dose Intravenous Methylprednisolone Pulse Therapy Produce Unacceptable Adverse Effects in Children?
AUTHORS:
Daishi Hirano, Shuichiro Fujinaga, Amane Endo, Tsuneki Watanabe, Hiroyuki Ida
KEYWORDS:
Methylprednisolone Pulse Therapy; Adverse Effects; Side Effects; Steroid; Children
JOURNAL NAME:
Open Journal of Nephrology,
Vol.3 No.4,
December
13,
2013
ABSTRACT: Background: Intravenous methylprednisolone pulse therapy
has been used since the late 1960s for acute transplant rejection or severe
renal involvement in systemic lupus erythematosus and primary
glomerulonephritis. However, reports of serious adverse effects such as
life-threatening cardiac arrhythmias and sudden death raise questions about its
safety. Objective: To investigate the incidence of significant adverse effects
associated with low-dose methylprednisolone pulse therapy (LDMPT) in pediatric
patients. Methods: We retrospectively analyzed adverse effects
during and after LDMPT in 68 patients (median age: 11.4 years; 43% male) with various
glomerular diseases who were admitted to Saitama Children’s
Medical Center between April 2007 and December 2010. LDMPT consisted of pulse
methylprednisolone (15-20 mg/kg; maximum 600 mg/d) for 3 consecutive days
weekly for 2-3 weeks. Results: Although adverse effects occurred in 54 of
68 patients (79%), most were mild and transient. Transient glycosuria was noted
in 46 patients (68%), hypertension in 6 (9%), elevated intraocular pressure in
6 (9%), hypokalemia in 5 (7%), and liver damage in 2 (3%). No late-onset
adverse effects such as osteoporotic fractures, steroid diabetes mellitus, or short
stature were observed. Conclusion: LDMPT appears to be relatively safe and
well tolerated in children with various glomerular diseases.