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Intravenous Steroids for Refractory Chemotherapy-Related Diarrhea: A Case Report
Kishan Patel1, Adrian Dang1, Mai M Makhlouf1
1College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, USA.
Cureus
|March 10, 2023
Summary
Chemotherapy-related diarrhea (CRD) can be refractory to standard treatments. Intravenous (IV) methylprednisolone offers a promising solution for severe CRD cases unresponsive to other therapies, leading to rapid symptom reduction and recovery.
Area of Science:
- Oncology
- Gastroenterology
- Clinical Pharmacology
Background:
- Chemotherapy-related diarrhea (CRD) is a common and often debilitating side effect of cancer treatment.
- Standard antidiarrheal therapies frequently fail to manage severe or refractory cases of CRD.
Observation:
- An 82-year-old female patient experienced severe, persistent diarrhea following chemotherapy initiation.
- The patient showed minimal response to multiple first-line treatments, including loperamide, diphenoxylate-atropine, octreotide, and oral budesonide.
- Severe hypotension and hypovolemia developed secondary to the persistent diarrhea.
Findings:
- Intravenous (IV) methylprednisolone, when added to existing antidiarrheal agents, led to significant symptom improvement.
- The patient's diarrhea resolved rapidly after initiation of IV steroids.
- Transition to oral steroids and a tapering regimen facilitated discharge and recovery.
Implications:
- Intravenous steroids represent a viable and effective treatment option for chemotherapy-related diarrhea refractory to standard therapies.
- Prompt administration of IV steroids can prevent severe complications like hypotension and hypovolemia.
- This approach may lead to faster recovery and improved patient outcomes in complex CRD cases.
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