Problems when withdrawing corticosteroids

1987 ◽  
Vol 25 (19) ◽  
pp. 73-75
Keyword(s):  
Hpa Axis ◽  
Corticosteroid Treatment ◽  
Hormone Deficiency ◽  
Prolonged Treatment ◽  
Disease Relapse ◽  
Catch Up ◽  
High Doses

Prolonged treatment with a corticosteroid, unless to replace hormone deficiency, carries well recognised risks which include hypertension, hyperglycaemia, osteoporosis and cushingoid appearance. Moreover, doses above 5–7.5mg prednisolone daily can suppress the hypothalamo-pituitary-adrenal (HPA) axis. Needlessly high doses should therefore be avoided and treatment should be withdrawn when it is no longer needed. Many unwanted effects then disappear or cease to progress - though osteoporosis may persist and the child whose growth has been suppressed may not fully catch up. Disease relapse is the commonest difficulty during or following withdrawal of corticosteroid treatment. This article discusses some other problems that may arise.

EFFECT OF HIGH DOSES OF OESTROGEN AND PROGESTERONE ON THE NORADRENALINE CONTENT OF THE SHORT ADRENERGIC NEURONS INNERVATING THE MALE GENITAL TRACT OF THE RAT

1970 ◽  
Vol 64 (3) ◽  
pp. 459-465 ◽  
Author(s):  
Ch. Owman ◽  
N.-O. Sjöberg ◽  
N. O. Sjöstrand ◽  
G. Swedin
Keyword(s):  
Genital Tract ◽  
Reproductive Tract ◽  
Female Genital Tract ◽  
Total Content ◽  
Prolonged Treatment ◽  
Noradrenaline Content ◽  
Adrenergic Neurons ◽  
Short Adrenergic Neurons ◽  
High Doses ◽  
Male Genital

ABSTRACT The effect of prolonged treatment with high doses of oestrogen and/or progesterone on the amount of adrenergic transmitter in the short adrenergic neurons of the male reproductive tract of castrated rats has been studied by chemical determinations and histochemical demonstration of noradrenaline. Oestrogen, progesterone, or a combination of both, had no overt effect on the total content or on the concentration of noradrenaline in the male genital organs. The results are discussed in the light of recent findings that the content of the noradrenaline transmitter in the short adrenergic neurons to the female genital tract is markedly influenced by these female sex hormones.

Corticosteroid treatment exacerbates bone osteopenia in mice with gonadal hormone deficiency–induced osteoporosis

2017 ◽  
Vol 105 ◽  
pp. 41-46 ◽  
Author(s):  
Riadh Badraoui ◽  
Nahed Amri ◽  
Nourhène Zammel ◽  
Rim Chaabane ◽  
Tarek Rebai
Keyword(s):  
Corticosteroid Treatment ◽  
Hormone Deficiency ◽  
Gonadal Hormone

THE USE OF RODENTS FOR STUDIES OF TOXICITY IN CONTRACEPTIVE RESEARCH

1974 ◽  
Vol 77 (1_Suppla) ◽  
pp. S34-S73 ◽  
Author(s):  
B. J. Leonard
Keyword(s):  
Oral Contraceptives ◽  
Epidemiological Studies ◽  
Convincing Evidence ◽  
Prolonged Treatment ◽  
Hormonal Contraceptives ◽  
Oncogenic Viruses ◽  
Carcinogenic Effect ◽  
Breakthrough Bleeding ◽  
High Doses ◽  
Different Strains

ABSTRACT After nearly two decades of clinical use of oral contraceptives, clinical studies have shown a few rare adverse reactions, including jaundice, venous thrombosis and pulmonary embolism, ischaemic cerebrovascular effects, hypertension, amenorrhoea, breakthrough bleeding, anxiety, depression, weight gain, and changes in libido. Preclinical studies in rodents dosed with oral contraceptives did not and would not be expected to reveal side effects of such low incidence. A carcinogenic effect can be produced in certain strains of mice and rats when oestrogens, progestogens and combinations of these hormones are given in high doses throughout their life span. The susceptibility to tumour induction by hormonal contraceptives is not consistent in different strains of mice and rats, and if there is little or no predictive value in rodents it is difficult to see how they can provide useful information of the potential carcinogenicity of any of these compounds in women. Ideally, carcinogenic testing of oral contraceptives should be conducted in animal species which have a similar metabolic disposition of the drugs and similar feedback mechanisms which control ovulation and menstruation to that of women: subhuman primates and guinea pigs possess some of these characteristics. Many previous studies indicate that carcinogenic tests in rodents have not been carried out in a very satisfactory manner. Improvements which are suggested include the use of strains with a low spontaneous tumour incidence, strains which are free of oncogenic viruses, and standardised diet. The use of extremely high doses should be avoided. To date there is no convincing evidence that oral contraceptives are carcinogenic in women, but further epidemiological studies following prolonged treatment will provide the most meaningful evidence.

scholarly journals Etiology of severe short stature below −3 SDS in a screened Finnish population

2020 ◽  
Vol 183 (5) ◽  
pp. 481-488
Author(s):  
Juho Kärkinen ◽  
Päivi J Miettinen ◽  
Taneli Raivio ◽  
Matti Hero
Keyword(s):  
Short Stature ◽  
University Hospital ◽  
Hormone Deficiency ◽  
Growth Monitoring ◽  
Growth Data ◽  
Target Height ◽  
Hospital District ◽  
Sitting Height ◽  
Catch Up ◽  
Severe Short Stature

Objective: To describe the etiology of severe short stature in the Helsinki University Hospital district covering a population of 1.2 million that is subject to frequent growth monitoring and screening rules during childhood. Design: Retrospective cohort study. Methods: We identified all subjects born 1990 or later with a height SD score <−3, after the age of 3 years, from the Helsinki University Hospital district growth database. A total of 785 subjects (376 females and 409 males) fulfilled our inclusion criteria; we reviewed their medical records and growth data and report their underlying diagnoses. Results: A pathological cause for short stature was diagnosed in 76% of the girls and 71% of the boys (P = NS). Syndromes were the most numerous pathological cause (n = 160; 20%), followed by organ disorders (n = 127; 16%), growth hormone deficiency (GHD, n = 94; 12%), SGA without catch-up growth (n = 73; 9%), and skeletal dysplasias (n = 57; 7%). Idiopathic short stature (ISS) was diagnosed in 210 (27%) subjects. The probability of growth-related pathology, particularly of a syndrome or skeletal dysplasia, increased with the shorter height SD score and the greater deviation from the target height. Sitting height to height SDS was increased in subjects with ISS, GHD, and SGA (all P < 0.01). Conclusions: Height <−3 SDS after 3 years of age usually results from a pathological cause and should be thoroughly investigated in specialized health care. The chance of finding a specific etiology increased with the severity of short stature, and the mismatch with target height.

Retinoids and pattern formation in a hydroid

Development ◽  
1984 ◽  
Vol 81 (1) ◽  
pp. 253-271
Author(s):  
W. A. Müller
Keyword(s):  
Retinoic Acid ◽  
Prolonged Treatment ◽  
Low Doses ◽  
Response Curves ◽  
Head Formation ◽  
Pulse Type ◽  
Head Activator ◽  
High Doses ◽  
Pattern Specification ◽  
Hydroid Polyps

The retinoids (retinol, retinal, retinoic acid) cause alterations in the pattern of limb elements in vertebrates (Summerbell & Harvey, 1983). As shown here, retinoids also influence pattern specification in hydroid polyps (Hydractinia echinata) in a way suggesting interference with the generation and transmission of signals responsible for the dimension and spacing of structures. A pulse-type application of low doses (e.g. retinoic acid 10-6 to 10-10 M, 4 h) causes metamorphosing primary polyps to develop more tentacles but fewer stolons per unit circumference, to shorten the length of the hydranth while the stolon elongates, and to bud secondary hydranths at high frequency 2–3 days after treatment (Fig. 3). Dose-response curves display optimum peaks. It is argued that the increase in budding rate is due to a reduction of the range of spacing signals emitted by the primary hydranth. In regenerating hydranths, low doses (10−10 to 10−9M) improve the rate of head formation, whilst medium doses (10−8 to 10−6M) result in more tentacles being regenerated. However, prolonged treatment with high doses (10−6 to 10−5 M) causes the animals to reduce all head structures and to transform eventually into stolons, in contravention of the rule of distal transformation that they normally obey (Fig. 8). The effects of the retinoids are counteracted by a putative morphogen, the endogenous inhibitor isolated from Hydra by Berking (1977). The Hydra-derived ‘head-activator’ displayed no stimulating effect on the number of tentacles and buds formed.

scholarly journals Acute Low-Dose Hydralazine-Induced Lupus Pneumonitis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Sarah K. Holman ◽  
Donique Parris ◽  
Sarah Meyers ◽  
Jason Ramirez
Keyword(s):  
Low Dose ◽  
Inflammatory Cells ◽  
Chest Ct ◽  
Prolonged Treatment ◽  
Drug Induced ◽  
Asthma Exacerbations ◽  
High Doses ◽  
Diagnostic Work ◽  
Work Up ◽  
Restrictive Pattern

A 35-year-old female was started on hydralazine 10 mg orally three times a day for treatment of postpartum hypertension. Three months later, after multiple unsuccessful courses of prednisone and antibiotics for presumed pneumonia and asthma exacerbations, her respiratory symptoms progressed in severity and she developed resting hypoxia. Previous diagnostic work-up included spirometry with a restrictive pattern, chest CT showing bilateral basilar consolidation, negative BAL, and nonspecific findings on lung biopsy of mild inflammatory cells. Review of systems was positive for arthralgia, lymphadenopathy, paresthesia, and fatigue that began four weeks after starting hydralazine. A clinical diagnosis of hydralazine-induced lupus (HIL) with pneumonitis was made. Antihistone antibodies were positive supporting a diagnosis of HIL. Management included cessation of hydralazine and a prolonged steroid taper. Within days, patient began improving symptomatically. Six weeks later, CT chest showed complete resolution of infiltrates. Genetic testing revealed she was heterozygous for N-acetyltransferase 2 (intermediate acetylator). Drug-induced lupus should be considered in patients with lupus-like symptoms taking medications with a known association. While the majority of HIL cases occur with high doses and prolonged treatment, cases of low-dose HIL have been reported in patients who are slow acetylators.

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