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August 1978, Vol 132, No. 8 >
Article | August 1978

Complications of Corticosteroid Therapy FREE

Mary Ellen Rimsza, MD
[+] Author Affiliations

Reprint requests to Department of Pediatrics, Maricopa County General Hospital, 2601 E Roosevelt St, Phoenix, AZ 85008 (Dr Rimsza).


Am J Dis Child. 1978;132(8):806-810. doi:10.1001/archpedi.1978.02120330078018.
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• The complications of corticosteroid therapy in children are protean. Perhaps the most important of these are adrenal insufficiency after withdrawal of steroids, immunosuppression, and growth failure. The physician who is caring for a child receiving corticosteroids must be aware of these common complications as well as the many less frequent side effects, such as cataracts, pseudotumor cerebri, pancreatitis, and steroid myopathy, to name a few. In all children, the risk of using corticosteroids should be weighed carefully before therapy with these agents is begun.

(Am J Dis Child 132:806-810, 1978)

REFERENCES

1 +
 Adverse ophthalmic effects of corticosteroids . Med Lett Drug Ther 10:20-22, 1968;.
2 +
Black RL, Oglesby RB, VonSallman L, et al:  Posterior subcapsular cataracts induced by corticosteroids in patients with rheumatoid arthritis . JAMA 174:166-171, 1960;.
3 +
Kobayashi Y, Akaishi K, Nishio T, et al:  Posterior subcapsular cataracts in nephrotic children receiving steroid therapy . Am J Dis Child 128:671-673, 1974;.
4 +
Fine RN, Offner G, Wilson WA, et al:  Posterior subcapsular cataracts: Posttransplantation in children . Ann Surg 182:585-589, 1975;.
5 +
Berkowitz JS, David DS, Sakai S, et al:  Ocular complications in renal transplant recipients . Am J Med 55:492-495, 1973;.
6 +
Ivey KJ, Dennssesten L:  Pseudotumor cerebri associated with corticosteroid therapy in an adult . JAMA 208:1698-1700, 1969;.
7 +
Walker AE, Adamkiewicz JJ:  Pseudotumor cerebri associated with prolonged corticosteroid therapy: Report of four cases . JAMA 188:779-784, 1964;.
8 +
Gordon RC, Kelsey WM:  Pseudotumor cerebri in congenital adrenal hyperplasia . Am J Dis Child 113:727-729, 1967;.
9 +
Weisberg LA, Chutorian AM:  Pseudotumor cerebri of childhood . Am J Dis Child 131:1243-1248, 1977;.
10 +
Wintrobe MM: Clinical Hematology . Philadelphia, Lea & Febiger Publisher, 1974;.
11 +
John TJ:  Leukocytosis during steroid therapy . Am J Dis Child 111:68-70, 1966;.
12 +
Floyd M, Muckle TJ, Kerr DN:  Prednisone-induced leukocytosis in nephrotic syndrome . Lancet 1( (607) ):1192-1193, 1969;.
13 +
Dale DC, Fauci AS, Wolff SM:  Alternate-day prednisone: Leukocyte kinetics and suscepti bility to infections . N Engl J Med 291:1154-1158, 1974;.
14 +
Azarnoff DL: Steroid Therapy . Philadelphia, WB Saunders Co, 1975;.
15 +
Conn HO, Blitzer BL:  Nonassociation of adrenocorticosteroid therapy and peptic ulcer . N Engl J Med 294:473-479, 1976;.
16 +
Baar HS, Wolff OH:  Pancreatic necrosis in cortisone-treated children . Lancet 1:812-815, 1957;.
17 +
Stumpf HH, Wilens SL, Somoza C:  Pancreatic lesions and peripancreatic fat necrosis in cortisone-treated rabbits . Lab Invest 5:224-235, 1956;.
18 +
Oppenheimer EH, Boitnott JK:  Pancreatitis in children following adrenal corticosteroid therapy . Bull Hopkins Hosp 107:297-306, 1960;.
19 +
Riemenschneider TA, Wilson JF, Vernier RL:  Glucocorticoid-induced pancreatitis in children . Pediatrics 41:428-437, 1968;.
20 +
Fisher DE, Bickel WH:  Corticosteroid-induced avascular necrosis . J Bone Joint Surg (Am) 53:859-872, 1971;.
21 +
Hill RB Jr:  Fatal fat embolism from steroid-induced fatty liver . N Engl J Med 265:318-320, 1961;.
22 +
Afifi AK, Bergman RA, Harvey JC:  Steroid myopathy . Johns Hopkins Med J 123:158-173, 1968;.
23 +
Byers RK, Bergman AB, Joseph MC:  Steroid myopathy . Pediatrics 29:26-36, 1962;.
24 +
Eberlein WR, Bongiovanni AM, Rodriquez CS:  Diagnosis and treatment: The complications of steroid treatment . Pediatrics 40:279-282, 1967;.
25 +
Cress RL, Blennerhassett J, MacDonald FR, et al:  Aseptic necrosis following renal transplantation . J Bone Joint Surg (Am) 50:1577-1590, 1968;.
26 +
Cole WG, Neal BW:  Corticosteroids and avascular necrosis of the femoral head in childhood . Aust Paediat J 11:243-246, 1975;.
27 +
Bennett WM, Strong D:  Arthralgia after high dose steroids . Lancet 1:332, 1975;.
28 +
Kobayashi O, Wada H, Utsumi J, et al:  Urinary lithiasis in children treated with adrenocorticosteroid hormone . Acta Med Biol 15:91-105, 1967;.
29 +
Daeschner CW, Singleton EB, Curtis JC:  Urinary tract calculi and nephrocalcinosis in infants and children . J Pediatr 57:721-732, 1960;.
30 +
Kerrebijn KF, Kroon JP:  Effect on height of corticosteroid therapy in asthmatic children . Arch Dis Child 43:556-561, 1968;.
31 +
Lam LN, Arneil GC:  Long-term dwarfing effects of corticosteroid treatment for childhood nephrosis . Arch Dis Child 43:589-594, 1968;.
32 +
Morris HG:  Growth and skeletal maturation in asthmatic children: Effect of corticosteroid treatment . Pediatr Res 9:579-583, 1975;.
33 +
Soyka LF:  Treatment of the nephrotic syndrome in childhood: Use of an alternate-day predisone regimen . Am J Dis Child 113:693-701, 1967;.
34 +
Root AW, Bongiovanni AM, Eberleen WR:  Studies of the secretion and metabolic effects of human growth hormone in children with glucocorticoid-induced growth retardation . J Pediatr 75:826-832, 1969;.
35 +
Sadeghi-Nejad A, Senior B:  Adrenal function, growth and insulin in patients treated with corticoids on alternate days . Pediatrics 43:277-283, 1969;.
36 +
Elders MJ, Wingfield BS, McNatt ML, et al:  Glucocorticoid therapy in children . Am J Dis Child 129:1393-1396, 1975;.
37 +
Cope CL: Adrenal Steroids and Disease . Philadelphia, JP Lippincott Co, 1972;.
38 +
Kobayashi A, Utsunomiya T, Horino M, et al:  Nephrosis, steroids, pancreatitis and diabetic ketoacidosis . Am J Dis Child 125:726-729, 1973;.
39 +
Ruiz JO, Simmons RL, Callender CO, et al:  Steroid diabetes in renal transplant recipients: Pathogenetic factors and prognosis . Surgery 73:759-765, 1973;.
40 +
Pennisi AJ, Fiedler J, Lipsey A, et al:  Hyperlipidemia in pediatric renal allograft recipients . J Pediatr 87:249-251, 1975;.
41 +
Price JE, Rigler LG:  Widening of the mediastinum resulting from fat accumulation . Radiology 96:497-500, 1970;.
42 +
Graber AL, Ney RL, Nicholson WE, et al:  Natural history of pituitary-adrenal recovery after long-term suppression with corticosteroids . J Clin Endocrinol 25:11-16, 1965;.
43 +
Aceto T, Beckhorn GD, Jorgensen JR, et al:  Iatrogenic ACTH-cortisol insufficiency . Ped Clin North Am 13:543-557, 1966;.
44 +
Morris HG, Jorgensen JR:  Recovery of endogenous pituitary-adrenal function in corticosteroid-treated children . J Pediatr 79:480-488, 1971;.
45 +
Ackerman GL, Nolan CM:  Adrenocortical responsiveness after alternate-day corticosteroid therapy . N Engl J Med 278:405-409, 1968;.
46 +
Zurier RB, Weissmann G:  Anti-immunologic and anti-inflammatory effects of steroid therapy . Med Clin North Am 57:1295-1305, 1973;.
47 +
MacGregor RR, Sheagren JN, Lipsett MB, et al:  Alternate-day prednisone therapy: Evaluation of delayed hypersensitivity responses, control of disease and steroid side effects . N Engl J Med 280:1427-1431, 1969;.
48 +
Tauesch HW:  Glucocorticoid prophylaxis for respiratory distress syndrome: A review of potential toxicity . J Pediatr 87:617-623, 1975;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
 Adverse ophthalmic effects of corticosteroids . Med Lett Drug Ther 10:20-22, 1968;.
2 +
Black RL, Oglesby RB, VonSallman L, et al:  Posterior subcapsular cataracts induced by corticosteroids in patients with rheumatoid arthritis . JAMA 174:166-171, 1960;.
3 +
Kobayashi Y, Akaishi K, Nishio T, et al:  Posterior subcapsular cataracts in nephrotic children receiving steroid therapy . Am J Dis Child 128:671-673, 1974;.
4 +
Fine RN, Offner G, Wilson WA, et al:  Posterior subcapsular cataracts: Posttransplantation in children . Ann Surg 182:585-589, 1975;.
5 +
Berkowitz JS, David DS, Sakai S, et al:  Ocular complications in renal transplant recipients . Am J Med 55:492-495, 1973;.
6 +
Ivey KJ, Dennssesten L:  Pseudotumor cerebri associated with corticosteroid therapy in an adult . JAMA 208:1698-1700, 1969;.
7 +
Walker AE, Adamkiewicz JJ:  Pseudotumor cerebri associated with prolonged corticosteroid therapy: Report of four cases . JAMA 188:779-784, 1964;.
8 +
Gordon RC, Kelsey WM:  Pseudotumor cerebri in congenital adrenal hyperplasia . Am J Dis Child 113:727-729, 1967;.
9 +
Weisberg LA, Chutorian AM:  Pseudotumor cerebri of childhood . Am J Dis Child 131:1243-1248, 1977;.
10 +
Wintrobe MM: Clinical Hematology . Philadelphia, Lea & Febiger Publisher, 1974;.
11 +
John TJ:  Leukocytosis during steroid therapy . Am J Dis Child 111:68-70, 1966;.
12 +
Floyd M, Muckle TJ, Kerr DN:  Prednisone-induced leukocytosis in nephrotic syndrome . Lancet 1( (607) ):1192-1193, 1969;.
13 +
Dale DC, Fauci AS, Wolff SM:  Alternate-day prednisone: Leukocyte kinetics and suscepti bility to infections . N Engl J Med 291:1154-1158, 1974;.
14 +
Azarnoff DL: Steroid Therapy . Philadelphia, WB Saunders Co, 1975;.
15 +
Conn HO, Blitzer BL:  Nonassociation of adrenocorticosteroid therapy and peptic ulcer . N Engl J Med 294:473-479, 1976;.
16 +
Baar HS, Wolff OH:  Pancreatic necrosis in cortisone-treated children . Lancet 1:812-815, 1957;.
17 +
Stumpf HH, Wilens SL, Somoza C:  Pancreatic lesions and peripancreatic fat necrosis in cortisone-treated rabbits . Lab Invest 5:224-235, 1956;.
18 +
Oppenheimer EH, Boitnott JK:  Pancreatitis in children following adrenal corticosteroid therapy . Bull Hopkins Hosp 107:297-306, 1960;.
19 +
Riemenschneider TA, Wilson JF, Vernier RL:  Glucocorticoid-induced pancreatitis in children . Pediatrics 41:428-437, 1968;.
20 +
Fisher DE, Bickel WH:  Corticosteroid-induced avascular necrosis . J Bone Joint Surg (Am) 53:859-872, 1971;.
21 +
Hill RB Jr:  Fatal fat embolism from steroid-induced fatty liver . N Engl J Med 265:318-320, 1961;.
22 +
Afifi AK, Bergman RA, Harvey JC:  Steroid myopathy . Johns Hopkins Med J 123:158-173, 1968;.
23 +
Byers RK, Bergman AB, Joseph MC:  Steroid myopathy . Pediatrics 29:26-36, 1962;.
24 +
Eberlein WR, Bongiovanni AM, Rodriquez CS:  Diagnosis and treatment: The complications of steroid treatment . Pediatrics 40:279-282, 1967;.
25 +
Cress RL, Blennerhassett J, MacDonald FR, et al:  Aseptic necrosis following renal transplantation . J Bone Joint Surg (Am) 50:1577-1590, 1968;.
26 +
Cole WG, Neal BW:  Corticosteroids and avascular necrosis of the femoral head in childhood . Aust Paediat J 11:243-246, 1975;.
27 +
Bennett WM, Strong D:  Arthralgia after high dose steroids . Lancet 1:332, 1975;.
28 +
Kobayashi O, Wada H, Utsumi J, et al:  Urinary lithiasis in children treated with adrenocorticosteroid hormone . Acta Med Biol 15:91-105, 1967;.
29 +
Daeschner CW, Singleton EB, Curtis JC:  Urinary tract calculi and nephrocalcinosis in infants and children . J Pediatr 57:721-732, 1960;.
30 +
Kerrebijn KF, Kroon JP:  Effect on height of corticosteroid therapy in asthmatic children . Arch Dis Child 43:556-561, 1968;.
31 +
Lam LN, Arneil GC:  Long-term dwarfing effects of corticosteroid treatment for childhood nephrosis . Arch Dis Child 43:589-594, 1968;.
32 +
Morris HG:  Growth and skeletal maturation in asthmatic children: Effect of corticosteroid treatment . Pediatr Res 9:579-583, 1975;.
33 +
Soyka LF:  Treatment of the nephrotic syndrome in childhood: Use of an alternate-day predisone regimen . Am J Dis Child 113:693-701, 1967;.
34 +
Root AW, Bongiovanni AM, Eberleen WR:  Studies of the secretion and metabolic effects of human growth hormone in children with glucocorticoid-induced growth retardation . J Pediatr 75:826-832, 1969;.
35 +
Sadeghi-Nejad A, Senior B:  Adrenal function, growth and insulin in patients treated with corticoids on alternate days . Pediatrics 43:277-283, 1969;.
36 +
Elders MJ, Wingfield BS, McNatt ML, et al:  Glucocorticoid therapy in children . Am J Dis Child 129:1393-1396, 1975;.
37 +
Cope CL: Adrenal Steroids and Disease . Philadelphia, JP Lippincott Co, 1972;.
38 +
Kobayashi A, Utsunomiya T, Horino M, et al:  Nephrosis, steroids, pancreatitis and diabetic ketoacidosis . Am J Dis Child 125:726-729, 1973;.
39 +
Ruiz JO, Simmons RL, Callender CO, et al:  Steroid diabetes in renal transplant recipients: Pathogenetic factors and prognosis . Surgery 73:759-765, 1973;.
40 +
Pennisi AJ, Fiedler J, Lipsey A, et al:  Hyperlipidemia in pediatric renal allograft recipients . J Pediatr 87:249-251, 1975;.
41 +
Price JE, Rigler LG:  Widening of the mediastinum resulting from fat accumulation . Radiology 96:497-500, 1970;.
42 +
Graber AL, Ney RL, Nicholson WE, et al:  Natural history of pituitary-adrenal recovery after long-term suppression with corticosteroids . J Clin Endocrinol 25:11-16, 1965;.
43 +
Aceto T, Beckhorn GD, Jorgensen JR, et al:  Iatrogenic ACTH-cortisol insufficiency . Ped Clin North Am 13:543-557, 1966;.
44 +
Morris HG, Jorgensen JR:  Recovery of endogenous pituitary-adrenal function in corticosteroid-treated children . J Pediatr 79:480-488, 1971;.
45 +
Ackerman GL, Nolan CM:  Adrenocortical responsiveness after alternate-day corticosteroid therapy . N Engl J Med 278:405-409, 1968;.
46 +
Zurier RB, Weissmann G:  Anti-immunologic and anti-inflammatory effects of steroid therapy . Med Clin North Am 57:1295-1305, 1973;.
47 +
MacGregor RR, Sheagren JN, Lipsett MB, et al:  Alternate-day prednisone therapy: Evaluation of delayed hypersensitivity responses, control of disease and steroid side effects . N Engl J Med 280:1427-1431, 1969;.
48 +
Tauesch HW:  Glucocorticoid prophylaxis for respiratory distress syndrome: A review of potential toxicity . J Pediatr 87:617-623, 1975;.

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