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[Complications during systemic corticosteroid therapy combined with orbital radiotherapy in patients with graves
Grzegorz Kulig1, Agnieszka Kaźmierczyk-Puchalska, Barbara Krzyzanowska-Swiniarska
1Klinika Endokrynologii, Nadciśnienia Tetniczego i Chorób Przemiany Materii Pomorskiej Akademii Medycznej w Szczecinie.
Objective:
An assessment of complications during systemic corticosteroid therapy combined with orbital radiotherapy in patients with thyroid eye disease.
Material:
101 patients including 86 women and 15 men hospitalized in the Endocrinology Department of Pomeranian Medical Academy in 1999-2002.
Methods:
During the first stage of therapy, methylprednisolone in a daily dose of 1.0 g was administered intravenously for the following 3 days. The number of methylprednisolone pulses ranged from 3 up to 6-7. Orbital radiotherapy was usually performed between 2 and 4 pulse. Ten daily doses of 200 cGy were given in 2 weeks. After the series of methylprednisone and orbital radiotherapy had been finished, patients were treated with prednisone (Encorton, Polfa) given orally with an initial dose of 60 mg/day.
Results:
During the first stage of therapy carbohydrate metabolism disturbances were observed in 27 patients. Cardio-vascular complications were noted in 8 patients. Four patients complained of digestive tract dysfunction. Acute psychosis was diagnosed in 3 patients. Twelve patients developed infectious diseases. During prednisone administration, 1 case of bacterial pneumonia, 1 purulent meningitis and 1 schizophrenia onset were observed. In prolonged ophthalmologic follow-up 3/101 patients with cataract needed surgical treatment.
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