No abstract available.
Prednisone*

BACKGROUND: Lepra reactions occur in 10-30% of patients with leprosy. The standard of treatment is prednisone. However , prolonged steroid use may cause side effects such as osteoporosis, hypertension, hyperlipidemia, atherosclerosis and infections. Fusidic acid targets cytokine systems responsible for the production of Type 1 lepra reaction (T1R) and erythema nodosum leprosum (ENL). It may be given as a steroid-sparing agent in treating lepra reactions.

OBJECTIVE: To determine the safety and efficacy of fusidic acid as a steroid-sparing agent in the treatment of  Type 1 and Type 2  lepra reactions.

METHODS: A randomized controlled trial was conducted on 67 subjects with lepra reactions, aged 18-60, each assigned to receive either prednisone or prednisone + fusidic acid for 12 weeks. Severity of lepra reactions were graded quantitatively using a modified scale by Walker et al and van Brakel et al, and qualitatively using modified National Leprosy Control Program (NLCP) Guidelines at baseline, weeks 2,4,6,8,10 and 12. Doses of prednisone needed to control lepra reactions were also noted at each follow up and statistical analyses were done . Adverse reactions were noted.

RESULT: Sixty subjects (89.55%) completed the study. The prednisone + fusidic acid group had lower quantitative and qualitative scores compared to the prednisone group. There were significant differences between the two groups for the quantitative severity scores (p=1.44x10-11) and qualitative severity grading (p=9.36x10-14) at week 12. The mean dose of prednisone was 21.5 mg in the prednisone group and 2 mg in the prednisone + fusidic acid group at week 12 (p=1.01x10-12). No adverse reactions were reported.

CONCLUSION: Fusidic acid tablet 250mg/tab two tablets three times a day is an effective and safe steroid-sparing agent for the treatment of lepra reactions.

Lupus nephritis is one of major complications of systemic lupus erythematosus, which determine the outcome of the disease. A case of lupus nephritis was admitted to our pediatric department and renal biopsy was done, which reveraled membranophroliferative type in electron-microscopy. He was treated with prednisone only and responded well in urinary findings. Now, he is maintained with low dose prednisone.
Biopsy ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Prednisone

Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.
Glucocorticoids ; Humans ; Immunoglobulins ; Inflammation ; Methylprednisolone ; Middle Aged ; Prednisone ; Retroperitoneal Fibrosis*

No abstract available.
Drug Therapy, Combination* ; Melphalan* ; Multiple Myeloma* ; Prednisone* ; Vincristine*

Twenty-one myasthenic patients were treated with high-dose daily prednisone regimen at Seoul National University Hospital from May 1983 to January 1985. Observations in relation to dosage, drug schedule, clinical responses, and sideeffects led us to following conclusions concerning the management of myasthenia gravis with steroid. In addition, factors influencing the result were considered. 1) Among 21 patients, twenty(95%) showed clinical improvement of variable degrees. 2) Significant improvement could be expected especially in male patients, in older patients, and in those with duration of myasthenia gravis less than 6 months prior to treatment. Performance of thymectomy or thymothymectomy, thymic pathology, and clinical grade at the time of therapy were not considered to affect the outcome. 3) Ten cases (48%) suffered from initial exacerbations, most of which occurred within the first four days of treatment. Steroid-induced crises developed in four cases with preexisting brittle or severe generalized myasthenia. 4) Period taken to show the initial response and the maximum improvement varied widely but majority of them occurred within 15 days and 70 days respectively. 5) Off-day weakness during the alternate-day schedule required special cautions and, if persitent, immediate return to daily schedule was desirable. 6) Thymectomy prior to steroid treatment was not always necessary but, when both regimens were scheduled together, preparation therapy with steroid thought to be more favorable. 7) Aside from initial exacerbations side-effects during the treatment were not remarkable, all of which disappeared with reduction of dosage.
Appointments and Schedules ; Humans ; Male ; Myasthenia Gravis* ; Pathology ; Prednisone ; Seoul ; Thymectomy

Childhood dermatomyositis seems to differ from the adult form by the presence of vasculitis and the late development of calcinosis. We report two patients with childhood dermatomyositis who were clinically characteristic and successfully treated with the followings. The first patient improved with intravenous gammaglobulin. The second patient improved with oral prednisone, methotrexate, and hydroxychloroquine.
Adult ; Calcinosis ; Dermatomyositis* ; Humans ; Hydroxychloroquine ; Methotrexate ; Prednisone ; Vasculitis

Objective: To review current available evidence that addresses the question regarding the efficacy of intravenous methylprednisolone and oral-prednisone treatment regimens in improving vision among optic-neuritis patients. Methods: A literature search for randomized controlled trials on the treatment of optic neuritis in adults using steroids was conducted. A total of 23 studies were identified in the search. Of these, the Optic Neuritis Treatment Trial (ONTT) was identified as the largest multicenter, randomized controlled trial that evaluated the effect of steroids in the treatment of optic neuritis in adults. The initial article regarding the results of this landmark study published in 1992 and follow-up reports focusing on the five-year and ten-year visual outcomes published in 1997 and 2004 were appraised for this review. Results: Treatment with high dose intravenous methylprednisolone followed by oral prednisone produced short-term accelerated visual recovery but provided no long-term benefit to vision. Most patients retained good to excellent vision following an attack of optic neuritis regardless of treatment received. A significantly increased risk of recurrence of optic neuritis in either eye (19 percent) was noted in the oral-prednisone treatment group. There were no significant differences among the treatment groups in the risk of development of clinically definite multiple sclerosis. Conclusion: Intravenous methylprednisolone followed by oral prednisone may be considered as treatment for patients with acute optic neuritis in whom there is a need to speed up recovery of vision. Considering that the use of oral prednisone alone was associated with an increased risk of recurrence of optic neuritis in either eye, no treatment is an option.
INFUSIONS, INTRAVENOUS ; METHYLPREDNISOLONE ; ADMINISTRATION, ORAL ; PREDNISONE ; OPTIC NEURITIS

Introduction: Epidermolysis Bullosa Acquisita (EBA) is a rare autoimmune blistering disease which presents in the skin and mucous membranes. The decrease in anchoring fibrils in the basement membrane zone causes separation of the epidermis from the dermis, resulting in its blistering presentation. The treatment plan will depend on the severity of the disease. The first-line treatment for mild EBA includes topical corticosteroids and immunomodulators such as dapsone and colchicine; while severe cases of EBA may be given intravenous immunoglobulins, systemic steroids, and immunosuppressants such as azathioprine and cyclophosphamide. Case Report: This is a case of a 50-year-old Filipino male who presented with a 2-year history of vesicles and tense bullae which evolved into papules, plaques and erosions with scarring and milia formation on the scalp and trauma-prone areas of the trunk and extremities. Clinical examination revealed multiple, well-defined, irregularly shaped erythematous papules and plaques with crusts, scales, erosions, pearl-like milia and scarring on the chest, back, upper, and lower extremities. The oral mucosa was moist with some ulcers on the tongue. Histopathologic examination using Hematoxylin and Eosin (H&E) stain revealed the absence of the epidermis with retention of dermal papillae suggestive of subepidermal clefting. Further examination with direct immunofluorescence (DIF) revealed monoclonal immunoglobulin (IgG) deposits demonstrating an intense linear fluorescent band at the dermoepidermal junction, consistent with Epidermolysis Bullosa Acquisita. Overall, the combined administration of prednisone, azathioprine, and colchicine resulted only in transient and incomplete resolution of lesions in this case of EBA. Conclusion The management of EBA is mostly supportive with the goal of minimizing complications. Combination treatments using steroids, colchicine, and azathioprine have been reported with various results. Its management remains challenging as most cases are refractory to treatment.
Epidermolysis Bullosa Acquisita ; bullous disease ; azathioprine ; colchicine ; prednisone

OBJECTIVETo search for the best method for increasing clinical therapeutic effect on nephrotic syndrome.

METHODSForty-one cases were randomly divided into 2 groups. The treatment group (n=22) were treated with acupoint-injection of Chinese medicine combined with prednisone, and the control group (n=19) with prednisone. Their therapeutic results were observed and compared.

RESULTSThe complete remission rate of 45.5% and the total effective rate of 86.4% in the treatment group were significantly higher than 31.6% and 63.2% in the control group, with a significant difference between the two groups in the total effective rate (P < 0.05); in the treatment group, blood lipids decreased, plasma proteins raised and immunologic function improved.

CONCLUSIONAcupoint-injection of Chinese medicine combined with prednisone can significantly increase therapeutic effect on nephrotic syndrome and strengthen immunologic function.