Abstract
High dose intravenous (iv) methylprednisolone (MP) pulse therapy is a highly effective immunosuppressive treatment used in various inflammatory and autoimmune diseases. Active, moderate to severe Graves' orbitopathy (GO) and neuropathy due to GO are indications for this treatment. Treatment with MP iv in GO is more effective than with oral glucocorticoids and better tolerated. In patients receiving MP iv there are significantly less adverse events, related to exogenous Cushing syndrome, such as weight gain, hypertension, Cushingoid feature. The European Group on Graves' Orbitopathy (EUGOGO) advises treatment with high doses iv MP pulses in patients with active, moderate to severe GO and neuropathy due to GO. However, recent studies indicate that this treatment may be associated with an increased risk of severe and fatal side effects due to the cardiovascular complications (acute cardiac arrest, pulmonary embolism, myocardial infarction, acute heart failure, stroke) or acute liver failure. The cardiovascular side effects after treatment with high doses of MP iv are probably due to the influence on hemostasis and cardiovascular system (increased blood pressure, influence on myocardium contractility and heart insufficiency). Treatment with high doses iv MP pulses can influence glucose metabolism, bone metabolism, psychosis. The exact pathomechanism of this side effects and safety profile of the treatment are so far unknown. It is very important to evaluate all risk factors, indications and contraindications before treatment with high doses iv MP pulses. All patients should conduct regular follow up during this treatment.
Highlights
High dose intravenous (iv) methylprednisolone (MP) pulse therapy is a highly effective immunosuppressive treatment used in various inflammatory and autoimmune diseases
Recent studies indicate that this treatment may be associated with an increased risk of severe and fatal side effects due to the cardiovascular complications or acute liver failure
The cardiovascular side effects after treatment with high doses of MP iv are probably due to the influence on hemostasis and cardiovascular system
Summary
High dose intravenous (iv) methylprednisolone (MP) pulse therapy is a highly effective immunosuppressive treatment used in various inflammatory and autoimmune diseases. Is the treatment with pulses of methylprednisolone safe? From 4th Congress of the Polish Thyroid Association 2013 Lodz, Poland.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have