Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case report
Corticosteroids are potent anti-inflammatory agents used as a mainstay of therapy in most of the rheumatologic disorders. Common side effects of pulse steroid therapy include hypertension, hyperglycemia, seizure, hypokalemia, and infection. We report a case of an 11-year-old girl with polyarticular...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-05-01
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| Series: | Journal of Family Medicine and Primary Care |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jfmpc.jfmpc_2167_22 |
| _version_ | 1826982654708285440 |
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| author | Saroj K. Tripathy Sarthak Das Archana Malik |
| author_facet | Saroj K. Tripathy Sarthak Das Archana Malik |
| author_sort | Saroj K. Tripathy |
| collection | DOAJ |
| description | Corticosteroids are potent anti-inflammatory agents used as a mainstay of therapy in most of the rheumatologic disorders. Common side effects of pulse steroid therapy include hypertension, hyperglycemia, seizure, hypokalemia, and infection. We report a case of an 11-year-old girl with polyarticular Juvenile idiopathic arthritis who developed bradycardia following pulse methylprednisolone therapy. On day 2 of methylprednisolone infusion, she developed bradycardia with a heart rate between 50 and 60/min. ECG was suggestive of sinus bradycardia. There was no evidence of dyselectrolytemia (Na—141 mmol/l, K—3.54 mmol/l, Ca—8.72 mg/l) or sepsis. The patient did not receive methylprednisolone on day 3 and vitals continued to be monitored. Her heart rate improved after 12 hours. In the mid of infusion on day 4, again the patient had bradycardia with a heart rate of 50–60/minute. Since she was hemodynamically stable, we continued the infusion, and bradycardia resolved in the next 8 hours. On follow-up after 2 weeks, she had some improvement in joint symptoms and normal heart rate. As per Naranjo adverse drug reaction probability scale, the adverse reaction in our case was probable with a score of 8. Although bradycardia associated with pulse steroid therapy is benign and is usually reversible following cessation of therapy, a baseline heart rate, ECG, and electrolyte level are suggested before infusion as a cautionary measure to minimize serious adverse events. |
| first_indexed | 2024-03-12T22:11:56Z |
| format | Article |
| id | doaj.art-a10ba3d43d9a45a39cc1649ae4596d48 |
| institution | Directory Open Access Journal |
| issn | 2249-4863 2278-7135 |
| language | English |
| last_indexed | 2025-02-18T06:24:03Z |
| publishDate | 2023-05-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-a10ba3d43d9a45a39cc1649ae4596d482024-11-11T11:07:50ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352023-05-011251006100810.4103/jfmpc.jfmpc_2167_22Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case reportSaroj K. TripathySarthak DasArchana MalikCorticosteroids are potent anti-inflammatory agents used as a mainstay of therapy in most of the rheumatologic disorders. Common side effects of pulse steroid therapy include hypertension, hyperglycemia, seizure, hypokalemia, and infection. We report a case of an 11-year-old girl with polyarticular Juvenile idiopathic arthritis who developed bradycardia following pulse methylprednisolone therapy. On day 2 of methylprednisolone infusion, she developed bradycardia with a heart rate between 50 and 60/min. ECG was suggestive of sinus bradycardia. There was no evidence of dyselectrolytemia (Na—141 mmol/l, K—3.54 mmol/l, Ca—8.72 mg/l) or sepsis. The patient did not receive methylprednisolone on day 3 and vitals continued to be monitored. Her heart rate improved after 12 hours. In the mid of infusion on day 4, again the patient had bradycardia with a heart rate of 50–60/minute. Since she was hemodynamically stable, we continued the infusion, and bradycardia resolved in the next 8 hours. On follow-up after 2 weeks, she had some improvement in joint symptoms and normal heart rate. As per Naranjo adverse drug reaction probability scale, the adverse reaction in our case was probable with a score of 8. Although bradycardia associated with pulse steroid therapy is benign and is usually reversible following cessation of therapy, a baseline heart rate, ECG, and electrolyte level are suggested before infusion as a cautionary measure to minimize serious adverse events.https://journals.lww.com/10.4103/jfmpc.jfmpc_2167_22bradycardiamethylprednisolonepulse therapy |
| spellingShingle | Saroj K. Tripathy Sarthak Das Archana Malik Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case report Journal of Family Medicine and Primary Care bradycardia methylprednisolone pulse therapy |
| title | Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case report |
| title_full | Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case report |
| title_fullStr | Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case report |
| title_full_unstemmed | Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case report |
| title_short | Bradycardia after pulse methylprednisolone therapy in a child—Uncommon side effect of a frequently used drug: A case report |
| title_sort | bradycardia after pulse methylprednisolone therapy in a child uncommon side effect of a frequently used drug a case report |
| topic | bradycardia methylprednisolone pulse therapy |
| url | https://journals.lww.com/10.4103/jfmpc.jfmpc_2167_22 |
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