High-dose corticosteroid therapy: association with noninflammatory synovial effusions

✍ Scribed by Edward V. Lally

• Publisher: John Wiley and Sons
• Year: 1983
• Tongue: English
• Weight: 420 KB
• Volume: 26
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780261018

✦ Synopsis

Corticosteroids administered in high doses have proved useful in the management of a variety of nonendocrine disorders (1,2). Although adverse reactions to long-term corticosteroid therapy are common and predictable (3-5), brief courses of high-dose corticosteroid therapy (HDCST), including pulse therapy, are generally well tolerated. However, Garrett and Paulus (6) found that more than half of their patients treated with pulse corticosteroid therapy experienced side effects including palpitations, facial flushing, gastraintestinal intolerance, hypertension, infection, glucose intolerance, and psychological disturbances. Anaphylaxis (7,8), seizures (9, lo), cardiac arrhythmias (11,12), and sudden death (12,13) have also been reported in association with this form of therapy.

The musculoskeletal side effects of HDCST have not been well studied. In particular, the effect of high doses of corticosteroids on articular structures has received little attention with the exception of avascular necrosis of bone. Patients may experience transient arthralgias during the course of HDCST (14- 17), but the development of synovial effusions has been reported only rarely. Transient noninflammatory joint effusions were described in patients treated with HDCST for the management of renal transplantation From the