Pluse Therapy with Dexamethasone in Reiter's Disease

A patient having Reiter's dsease manifesting as fever, arthritis and skin lesions failed to respond to adequate treatment with oxyphenbutazone, prednisolone, tetracycline, methotrexate, levamisol and haemodialysis in various combinations. Pulse therapy, however, consisting of intravenous infusions of 140 mg dexamethasone in 500 ml of 5% glucose on 3 consecutive days every month led to a dramatic improvement, The patient who was earlier bed-ridden because of, arthritis, was able to walk back home within'6 months. The side effects of systemic corticosteroids with this mode of treatment were far milder compared to the usual mode of therapy in spite of a much higher dose being used during pluse therapy.