Pulse steroid therapy

Abstract

Intravenous supra-pharmacological doses of corticosteroids are used in various inflammatory and autoimmune conditions because they are cumulatively less toxic than sustained steroid treatment at lower quantitative dosage. Their action is supposed to be mediated through non-genomic actions within the cell. Common indications for use in children include steroid resistant and steroid dependent nephrotic syndrome, rapidly progressive glomerulonephritis, systemic vasculitis, systemic lupus erythematosus, acute renal allograft rejection, juvenile rheumatoid arthritis, juvenile dermatomyositis, pemphigus, optic neuritis, multiple sclerosis and acute disseminated encephalomyelitis. Methylprednisolone and dexamethasone show similar efficacy in most conditions. Therapy is associated with significant side effects including worsening of hypertension, infections, dyselectrolytemia and behavioral effects. Adequate monitoring is essential during usage.

Neurological Symptoms of Sarcoidosis-induced Small Fiber Neuropathy Effectively Relieved with High-dose Steroid Pulse Therapy

“…The effects of steroid pulse therapy are so rapid that they cannot be explained by genomic mechanisms alone, and the pharmacological effects of this treatment are qualitatively different from those of non-pulse steroid therapy (18). This may be another reason why steroid therapy was effective in our patient, while conventional steroid administration was ineffective in previous cases.…”

“…are not yet understood (18), it is known that pulse therapy is capable of transporting a sufficient amount of steroids to areas not easily accessed with non-pulse therapies and can induce the apoptosis of peripheral T-cells within 30 minutes after administration in vitro (19). The effects of steroid pulse therapy are so rapid that they cannot be explained by genomic mechanisms alone, and the pharmacological effects of this treatment are qualitatively different from those of non-pulse steroid therapy (18).…”

Pulse methylprednisolone in allergic bronchopulmonary aspergillosis exacerbations

“…Long-term steroid use is associated with downregulation of steroid receptors and, hence, creation of a steroid resistance state [18]. Use of high doses of methylprednisolone may overcome this effect by its non-genomic physicochemical actions, which are independent of the steroid receptors [19].…”

“…Therapeutic bronchoscopy should be considered before pulse methylprednisolone in those with large airway collapse, [20]. The administration of high doses of methylprednisolone may be rarely associated with complications like cardiac arrhythmias and circulatory collapse usually following rapid administration [19]. Hence, the infusion should be given gradually over 2 h, and the patients should be closely observed during the pulse therapy.…”

ANTIHYPERTENSIVE ACTIVITY OF EXTRACT AND FRACTIONS OF MATOA (POMETIA PINNATA J. R & G FORTS) LEAVES

“…Mineralocorticoids cause retention of sodium and water in the body until diuresis occurs due to increase pressure on the kidney. No further retention of sodium and water occurs, but general sodium and water level in the body is slightly increased [4][5][6][7].…”