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Related Concept Videos

Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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),...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...

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Related Experiment Video

Updated: Jun 5, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Risks and Management of Glucocorticoid Therapy for Patients with Rheumatic Disease Having Surgery.

Kunjam Modha1, Christopher Whinney2

  • 1Department of Hospital Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. modhak@ccf.org.

Current Rheumatology Reports
|June 3, 2026
PubMed
Summary

Perioperative glucocorticoid use in rheumatic diseases carries risks like infection and wound complications. Most patients do not require stress dosing; continuation of home doses is generally sufficient.

Keywords:
GlucocorticoidsPerioperativeRheumatic diseaseStress steroids

Related Experiment Videos

Last Updated: Jun 5, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Area of Science:

  • Rheumatology
  • Anesthesiology
  • Surgical Sciences

Background:

  • Glucocorticoids are frequently used in rheumatic diseases.
  • Perioperative management of these patients requires careful consideration of steroid use.

Purpose of the Study:

  • To review the risks and benefits of perioperative glucocorticoid use.
  • To characterize outcomes in patients with rheumatic diseases undergoing surgery.

Main Methods:

  • Literature review of studies on glucocorticoid use in the perioperative period.
  • Analysis of risks including surgical site infection, wound dehiscence, pneumonia, and readmissions.
  • Evaluation of adrenal insufficiency and stress dosing guidelines.

Main Results:

  • Glucocorticoids are associated with increased risks of surgical site infection, wound dehiscence, pneumonia, unplanned intubation, and readmissions.
  • Perioperative adrenal insufficiency is rare.
  • Current guidelines for knee and hip arthroplasties do not recommend stress dosing; continuation of home doses is adequate for most patients.

Conclusions:

  • Stress dosing of glucocorticoids should be reserved for specific cases: biochemically confirmed adrenal dysfunction or patients on supraphysiologic doses undergoing moderate to high-risk surgery.
  • Careful perioperative glucocorticoid management is crucial for patients with rheumatic diseases.