Related Experiment Videos

Frequent methylprednisone pulse therapy is a risk factor for steroid cataracts in children

Yasuhito Nerome1, Hiroyuki Imanaka, Yukiko Nonaka

  • 1Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. nerome@m.kufm.kagoshima-u.ac.jp

Pediatrics International : Official Journal of the Japan Pediatric Society
|January 16, 2009
PubMed

Insights

Corticosteroid therapy in children under 12, especially intravenous methylprednisolone pulse therapy (IVMP), increases the risk of developing cataracts. Regular eye exams are crucial for young patients undergoing long-term steroid treatment for rheumatic diseases.

Area of Science:

  • Pediatric rheumatology
  • Ophthalmology
  • Pharmacology

Background:

  • Corticosteroids are widely used by pediatricians for treating various conditions, including rheumatic diseases.
  • While steroid-induced cataracts are a known side effect, specific risk factors remain unclear.

Purpose of the Study:

  • To identify predictive risk factors for the development of steroid-induced cataracts in pediatric patients.
  • To evaluate the association between corticosteroid therapy and cataract formation in children with rheumatic disease.

Main Methods:

  • Retrospective evaluation of patients with rheumatic disease undergoing steroid therapy.
  • Analysis of factors including age at therapy initiation, cumulative dose, daily dose, sex, and IVMP use.

Main Results:

  • Initiation of steroid therapy in children under 12 years old is a significant risk factor for cataracts (P=0.041).
  • Intravenous methylprednisolone pulse therapy (IVMP) is also a significant risk factor (P=0.046).
  • Cumulative dose, sex, and daily dose of corticosteroids were not significantly associated with cataract formation.

Conclusions:

  • Younger children treated with corticosteroids, particularly IVMP for rheumatic diseases, require frequent ophthalmological examinations.
  • Early detection of cataracts in this population is essential to prevent amblyopia.
Abstract

Related Concept Videos

Ophthalmic Drug Delivery Systems01:23

Ophthalmic Drug Delivery Systems

Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...