• Title/Summary/Keyword: steroid therapy

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Efficacy and Safety of Cyclosporine Therapy in Children with Nephrotic Syndrome (소아 신증후군에서의 Cycplosporine의 치료효과 및 안전성)

  • Chon, Myoung-Hun;Lee, Suk-Hyang;Jin, Dong-Kyu;Sohn, Kie-Ho;Choi, Kyung-Eob
    • Korean Journal of Clinical Pharmacy
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    • v.14 no.1
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    • pp.11-23
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    • 2004
  • Although most children with idiopathic nephrotic syndrome respond to corticosteroid therapy, many responders show steroid dependency and frequent relapse. In these children, one of the major problems is the serious side effects resulting from continuous steroid therapy. Thus, this study was conducted to assess the therapeutic efficacy and safety of six-month cyclosporine treatment with the low-dose deflazacort therapy in children with nephrotic syndrome. Thirty children with steroid dependence (SD), frequent relapse (FR) and steroid resistance (SR) were enrolled in this study. They were treated with 6-month oral cyclosporine $(Cypol-N^{(R)})$ plus the low-dose deflazacort $(Calcort^{(R)})$ therapy at Samsung Medical Center from September 2002. The dosage of cyclosporine was started at 5 mg/kg/day and was monthly adjusted to maintain clinical remission and/or a trough blood level, while deflazacort dosage was reduced gradually. Clinical evaluation and monitoring of cyclosporine toxicity were performed every $2\sim4$ weeks. Outcomes were compared to the latest sir-month period of steroid only therapy before cyclosporine treatment. Student's t-test and ANOVA were used for statistical analysis. Out of 28 children with SD and FR, 23 $(82.1\%)$ sustained remission, and 5 $(17.9\%)$ experienced 1 or 2 relapses during therapy. Out of 2 children with SR, 1 child sustained remission, and 1 child showed no response. The mean duration of remission and occurrence of relapse were significantly improved (p <.0001). In addition, the mean dosage of steroid was significantly reduced (p=.003). Although a number of adverse effects occurred in this study, they were not so serious as to necessitate discontinuation of the therapy. No nephrotoxicity was observed. Twenty out of the 28 children who had been in remission relapsed after withdrawal of cyclosporine. Fifteen of these children showed relapse within a month. These results demonstrated that the combination of cyclosporine with the low-dose deflazacort was efficient and safe in children with SD and FR during the six-month treatment. However, further studies are necessary in order to resolve the problem of high relapse rate after discontinuation of cyclosporine.

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The Change of Muscle Fiber by Aquatic Exercise on Rats Induced by Steroids Injection (스테로이드를 투여한 흰쥐에서 수중운동에 의한 근 섬유의 변화)

  • Yoon, Se-Won;Lee, Jung-Woo;Choi, Suk-Joo
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.1 no.2
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    • pp.21-30
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    • 2003
  • The purpose of this study was to know the effect of aquatic-exercise on muscle atrophy which induced by steroid injection. The forty-eight Sparague-Dawley adult male rats were assigned to the 4 groups; GroupI(distilled water injection), GroupII(steroid injection), GroupIII(distilled water injection and aquatic exercise), GroupIV(steroid injection and aquatic exercise). We observed their body weight, histological change by PAS stein. The results of this study were as follows; 1. After 2 weeks, the change of weights appeared that non-steroid injection groups increase weight and steroid injection groups decreased weight hasty. after 4 weeks, weights recovered from weight before test. It was possible to explain the change of weight by type II muscle fiber increase. 2. In histological change of muscle fibers, atrophy didn't observed in test group I, because type II muscle fibers were developed well. we observed not only injury of muscle fiber and muscle atrophy but specifically grouping type I muscle fiber in test group II. normal arrangement of muscle fibers were visible in test group and type II muscle fibers increased. we could observe muscle recovery because of type II muscle fibers increase in test group IV. therefore, it was seem that type II cell was recovering through aquatic exercise.

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Colonic Angioectasia in an Adolescent Boy with Hoyeraal-Hreidarsson on Long-Term Anabolic Steroid Therapy

  • Khalaf, Racha;Cuffari, Carmen
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.68-71
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    • 2018
  • Androgen therapy has proven efficacy in treating patients with bone marrow failure who are not candidates for bone marrow transplantation. Herein, we report on a case of colonic angioectasia secondary to oxymetholone use in an adolescent patient with Hoyeraal-Hreidarsson syndrome (HHS). A 13-year-old Caucasian male with HHS characterized by cerebellar hypoplasia, developmental delay, microcephaly, esophageal strictures and myelodysplasia presented with severe hematochezia from colonic angioectasia secondary to long-term oxymetholone therapy. These vascular lesions resolved spontaneously once this anabolic steroid was discontinued. While androgen therapy is often recommended for certain anemias and myelodysplastic syndromes, clinicians should be aware of the potential complication in developing these perceived uncommon colonic angioectasias. Moreover, pediatric gastroenterologists should familiarize themselves in identifying these vascular lesions by colonoscopy, especially among the high risk groups on long-term anabolic steroid therapy.

The Effect of Recombinant Human Growth Hormone on Growth in Children with Nephropathy Receiving Long-term Steroid Therapy (장기간의 스테로이드 치료를 받고 있는 신병증 환아에서 Recombinant Human Growth Hormone의 효과)

  • Kim, Se-Jin;Kim, Sun-Kyoung;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.142-151
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    • 2006
  • Purpose : Growth retardation is one of the serious problems in children with nephropathy requiring long-term steroid therapy. We observed the efficacy and safety of recombinant human growth hormone(rhGH) on the growth in children with long-term steroid therapy. Methods : We studied 60 children(male 47, female 13) with nephropathy who received rhGH(1 U/kg/week) for more than 0.5 years($1.39{\pm}1.12$). Their mean age was 11.0 years($11.17{\pm}2.62$). They received steroid therapy from January 1987 through July 2005, and the mean duration of steroid therapy was $4.32{\pm}2.97$ years. Among the patients, there were 32 nephrotic syndrome, 9 IgA nephropathy, 4 mesangial proliferative glomerulonephritis, 4 focal segmental glomerulosclerosis, 2 Henoch $Sch\ddot{o}nlein$ nephritis, 2 Alport syndrome and 7 other cases. Data were gathered on the growth parameters, such as growth velocity, height standard deviation score(SDS), IGF-1, IGFBP-3, bone mass density(BMD) and general chemistry changes. Results : Height velocity increased significantly with rhGH therapy from $3.29{\pm}1.95$ to $8.66{\pm}3.75$(cm/yr) and height SDS decreased from $-0.72{\pm}0.93$ to $-1.04{\pm}0.86$ at one year after steroid therapy but increased to $-0.55{\pm}0.96$ at one year after rhGH administration(P<0.05). BMD improved from $0.71{\pm}0.14$ to $0.79{\pm}0.15g/cm^2$(P<0.05). IGF-1 increased from $445.09{\pm}138.01$ to $506.62{\pm}181.31ng/mL$(P<0.05). IGFBP-3 decreased from $4073.75{\pm}700.78$ to $3933.61{\pm}789.25ug/L$ numerically, but there was no statistically significant difference(P=0.533). Conclusion : The administration of rhGH in the short stature patients who received long-term steroid therapy showed improvement in growth parameters such as SDS, growth velocity, and BMD without significant side-effects or changes in the biochemical parameters.

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A Case Study of Chronic Plantar Pompholyx Including Steroids Side Effects (스테로이드제제 부작용을 동반한 만성 족부 한포진 치험 1례)

  • Kang, Da-Hae;Kim, Jung-Hyun;Lim, Hae-Won;Kim, Jee-Young;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.24 no.1
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    • pp.181-191
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    • 2011
  • Backgrounds : Pompholyx is a distinctive reaction pattern presenting as symmetric vesicular hand and foot dermatitis. Other than acute symptoms like itching and vesicles, chronic changes with scaling, fissure and pain may follow. As patients are treated by steroid for a long period, it tends to present side effects after quitting steroid treatment. Objectives : This study was carried out to investigate the effect of carbon arc lamp therapy and oriental medical therapy that venesection therapy, ointments and herbal medicine on chronic plantar pompholyx including steroids side effects. Methods : We treated one case of chronic plantar pompholyx which had continued about 10 years, including steroids side effects with venesection therapy, carbon arc lamp therapy, ointments and herbal medicine. To evaluate the results of this treatment, we categorized symptoms into six items which are vesicles, itching, fissures, pain, erosions and scales. Results : Except mild itching, vesicles and scales in a small area, all the symptoms were subsided. Conclusions : It is considered that various kinds of oriental medical therapy including carbon arc lamp therapy could replace steroid therapy which has many side effects.

Efficacy of Early Steroid Therapy in Acute Interstitial Pneumonia (급성 간질성 폐렴에서 조기 부신피질호르몬 치료의 효과)

  • Lee, Kye-Young;Jee, Young-Koo;Kim, Youn-Seup;Myong, Na-Hye;Park, Jae-Seuk
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.519-528
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    • 2002
  • Background : Steroid therapy has been shown to improve the clinical outcome in acute respiratory distress syndrome (ARDS) patients with histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. Because the histopathological features of acute interstitial pneumonia(AIP) are identical with that of ARDS, early steroid therapy was used in AIP patients who had histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. We analyzed seven years of our experience to evaluate the efficacy of early steroid therapy in AIP. Materials and Methods : A retrospective review was performed on AIP patients who received steroid therapy within 7 days of mechanical ventilatory support in Dankook university Hospital between May 1995 and May 2002. AIP was diagnosed clinically by ARDS without a known cause of the etiology and pathologically by a lung biopsy showing a fibroproliferative stage of diffuse alveolar damage. The clinical response and physiologic parameters were evaluated during steroid therapy. Results : Five AIP patients received intravenous methylprednisolone (1-2 mg/kg every 6 hours) after $0.6{\pm}1.7$ days of mechanical ventilatory support. Lung biopsies were performed after $1.8{\pm}1.4$ days of mechanical ventilatory support. Four patients(80%) survived and were extubated after $2.8{\pm}0.4$ days of steroid therapy with improvement in the $PaO_2/FiO_2$ ratio ($127.4{\pm}10.0$ at day 0 to $223.8{\pm}37.6$ at day 7) by steroid therapy. However, one patient(20%) died of respiratory failure after 15 days of steroid therapy. Conclusion : Early steroid therapy sppears to be beneficial in AIP patients without evidence of infection. However, as our study group was too small, further large scale studies to define the effectiveness of steroids are required.

A Clinical Study about Steroid induced Myopathy in patient with latrogenic Cushing Syndrome and Compression Fracture of L-spine. (의인성 쿠싱 증후군과 동란하여 발생한 스테로이드 근병증과 요추 압박 골절 1예)

  • Yang, Dong-Ho;Lim, Chang-Sun;Kim, Sung-Keun;Lee, Kyung-Yun;Sin, Hyun-Sueng;Yim, Jun-Hyok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.149-161
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    • 2009
  • Objective : The purpose of this study is to report the improvement after the acupuncture therapy and herbal medicine about a patient who has latrogenic Cushing with steroid induced myopathy and compression fracture of L-spine. Methods : We treated the patient with Neutral Blood Stasis herbal acupuncture, acupuncture therapy and herbal medication. Results : We have experienced one case of latrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine. This case improved significantly through acupuncture and herbal medication treatment. Conclusions : This study suggests manual acupuncture therapy and herbal medication is effective for the improvement of latrogenic Cushing syndrome with steroid induced myopathy and compression fracture of L-spine.

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A Case Report of Lupus Nephritis in a Child Patient Treated with Jasinwhalhyul-tang and Steroid Therapy (자신활혈탕(滋腎活血湯)과 스테로이드 병합요법으로 관해를 보인 소아 낭창성 신염 환자 1예)

  • Chang, Sun-Kyu;Choi, Jeong-Sik;Ann, So-Hyun;Cho, Chung-Sik;Kim, Cheol-Jung
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.819-826
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    • 2008
  • In childhood systemic lupus erythematosus patients, renal involvement is closely related to mortality and morbidity of the disease. Therefore early diagnosis and treatment are essential to improving prognosis. We saw a child who had hematuria, albuminuria, anorexia, fatigue, and light hyper sensitiveness. He was diagnosed as lupus nephritis (WHO Class II+IV) and treated with ACE inhibitor and steroid therapy for 12 months. However, clinical improvement was not shown. So we treated him with herbal formula (Jasinwhalhyul-tang: Zishenhuoxue-tang) and steroid therapy. After 17 months of treatment, hematuria disappeared and clinical symptoms and albuminuria had improved significantly.

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Strongyloidiasis in a Diabetic Patient Accompanied by Gastrointestinal Stromal Tumor: Cause of Eosinophilia Unresponsive to Steroid Therapy

  • Won, Eun Jeong;Jeon, Jin;Koh, Young-Il;Ryang, Dong Wook
    • Parasites, Hosts and Diseases
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    • v.53 no.2
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    • pp.223-226
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    • 2015
  • We report here a case of strongyloidiasis in a 72-year-old diabetic patient (woman) accompanied by gastrointestinal stromal tumor receiving imatinib therapy, first diagnosed as hypereosinophilic syndrome and treated with steroids for uncontrolled eosinophilia. She suffered from lower back pain and intermittent abdominal discomfort with nausea and diagnosed with gastrointestinal stromal tumor. After post-operative imatinib treatment eosinophilia persisted, so that steroid therapy was started under an impression of hypereosinophilic syndrome. In spite of 6 months steroid therapy, eosinophilia persisted. Stool examination was performed to rule out intestinal helminth infections. Rhabditoid larvae of Strongyloides stercoralis were detected and the patient was diagnosed as strongyloidiasis. This diagnosis was confirmed again by PCR. The patient was treated with albendazole for 14 days and her abdominal pain and diarrhea improved. This case highlights the need for thorough investigation, including molecular approaches, to test for strongyloidiasis before and during steroid therapies.

The Effect of Neuromuscular Electrical Stimulation(NMES) on Skeletal Muscle Weight and Myofibrillar Protein Content of Rats with Injection. (신경근전기자극이 스테로이드 투여 흰쥐의 골격근 무게 및 단백질 함량에 미치는 효과)

  • Yoon, Se-Won;Shin, Min-Chul;Jung, Dae-In;Kim, Yong-Nam
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.1 no.1
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    • pp.31-43
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    • 2003
  • The present studies are designed to determine whether the NMES can affect the muscle atrophy in rats following administration of steroid. Rats were divided into four groups: 1) Control group treated with administration of distilled water. 2) The group treated with administration of steroid. 3) The group treated with NMES once a day after adminstration of steroid. 4) The group treated with NMES twice a day after administration of steroid. The muscle atrophy was induced by one week administration of dexamethasone once a day by 3 mg/kg. The change in the structure of muscle fiber and the amount. of myofibril protein and gastrocnemius were determined after every week dissection of the tissues. The results were as follows; 1. The administration of steroid significantly affected the decrease in the weight, but NMES did not affect the inhibition of decrease in the weight. 2. The weight of gastrocnemius in the group once treated with NMES was changed two weeks later; similarly in the group twice treated with NMES significantly did two or three weeks later. These indicated that NMES affected the muscular activation of gastrocnemius(p<.05). 3. The changes in the amount of gastrocnemius protein by NMES might, indicate that NMES activated the capacity of synthesis of muscle fiber protein(p<.05).

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