Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas
Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas
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DOI：
10.1001/archderm.140.8.963
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发表时间：
2004-08-01
影响因子：
--
通讯作者：
Nopper, AJ
中科院分区：
文献类型：
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作者：
George, ME;Sharma, V;Nopper, AJ
目的：评估血管瘤婴儿全身性糖皮质激素 (GS) 治疗的短期和长期不良反应。设计：对 3 年期间接受 GS 治疗血管瘤的婴儿进行回顾性图表审查。地点：三级保健儿童医院患者：在 141 名患有血管瘤的患者中，22 人接受了 GS 治疗。干预措施：至少 1 个月的 GS 治疗最小起始剂量为每天 0.5 mg/kg。 结果测量：人口统计学和人体测量、GS 治疗的起始剂量和持续时间、家长主观担忧、与血管瘤相关的并发症、辅助治疗、早晨皮质醇水平和/或促肾上腺皮质激素刺激试验结果。 结果：平均起始剂量为每天 2.23 mg/kg；平均治疗时间为28.1周。 1.6 名患者 (73%) 抱怨烦躁、烦躁或失眠。在 10 名患者 (45%) 中观察到高血压，定义为 3 次或多次收缩压高于 105 转汞柱。在接受评估的 15 名患者中，有 13 名 (87%) 早晨皮质醇水平异常。接受测试的 3 名婴儿中，有 2 名的低剂量促肾上腺皮质激素刺激试验结果异常。 结论：虽然 GS 治疗婴儿血管瘤的总体耐受性良好，但行为改变、失眠和胃肠道症状是家长常见的担忧。经常观察到高血压和下丘脑-垂体-肾上腺轴抑制。接受长期 GS 治疗血管瘤的婴儿应仔细监测这些潜在的不良反应。
Objective: To evaluate the short- and long-term adverse effects of systemic glucocorticosteroid (GS) therapy in infants with hemangionias.Design: Retrospective chart review of infants treated with GSs for hemangiomas during a 3-year period.Setting: Tertiary care children's hospitalPatients: Of 141 patients identified with hemangiomas, 22 were treated with GSs.Interventions: Minimum of 1-month GS therapy at a minimum starting dose of 0.5 mg/kg per day.Outcome Measures: Demographic and anthropometric measurements, starting dose and duration of GS therapy, subjective parental concerns, complications related to hemangioma, adjunctive treatment, and morning cortisol levels and/or results of corticotropin stimulation tests.Results: The average starting dose was 2.23 mg/kg per day; average length of therapy was 28.1 weeks. Complaints of irritability, fussiness, or insomnia were identified in 1.6 patients (73%). Hypertension, defined as 3 or more episodes of systolic blood pressure higher than 105 turn Hg, was observed in 10 patients (45%). Morning cortisol levels were abnormal in 13 (87%) of the 15 patients evaluated. Low-dose corticotropin stimulation test results were abnormal in 2 of the 3 infants tested.Conclusions: While GS therapy for infantile hemangiomas was tolerated well overall, changes in behavior, insomnia, and gastrointestinal symptoms were common parental concerns. Hypertension and hypothalamic-pituitary-adrenal axis suppression were observed frequently. infants undergoing long-term GS treatment of hemangiomas should be monitored carefully for these potential adverse effects.