Special Risks and Management Requirements in Children Receiving Chronic Steroid Therapy
Glucocorticoids are used extensively in the treatment of a wide variety of pediatric illnesses. Although extremely effective as anti-inflammatory and immunosuppressive agents, their use is associated with numerous side effects. Short-term adverse consequences include hyperglycemia, increased appetite and weight gain, fluid retention, mood changes, hypertension, peptic ulceration, and aseptic necrosis of the femoral head. Long-term side effects include osteoporosis, cataracts, myopathy, immunosuppression, and growth failure. In addition, prolonged use of glucocorticoids suppresses the hypothalamic-pituitary-adrenal (HPA) axis.
The impact of exogenous steroid use on the HPA axis depends on:
Amount of steroid used In general, larger than physiologic doses of steroid are required to suppress the axis.
