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Low-dose steroid-induced bradyarrhythmias and treatment refractory hypokalaemia: a case report

Published online by Cambridge University Press:  03 December 2020

Arindam Ghosh Open the ORCID record for Arindam Ghosh [Opens in a new window] ,
Saba Annigeri Open the ORCID record for Saba Annigeri [Opens in a new window]  and
Anupama Nair
Arindam Ghosh
Affiliation:
Department of Paediatrics, Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India
Saba Annigeri*
Affiliation:
Department of Paediatrics, Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India
Anupama Nair
Affiliation:
Department of Paediatrics, Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India
*
Author for correspondence: Saba Annigeri, Department of Paediatrics, Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India. Tel: +919483477054. E-mail: [email protected]
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Abstract

Corticosteroid therapy has become an important modality of treatment for diseases in which rapid control of immunoinflammatory processes is required. However, one of the serious, but less known adverse effect of this therapy is cardiac arrhythmias. This includes both tachyarrhythmias and bradyarrhythmias. Corticosteroid use may also be associated with electrolyte imbalances like hypokalaemia by its mineralocorticoid activity. Those side effects are mainly seen with high-dose intravenous methyl-prednisolone or oral pulse dose prednisolone therapy. Here we report our experience in a child with warm idiopathic autoimmune haemolytic anaemia who developed sinus bradyarrhythmias and treatment refractory hypokalaemia during low-dose steroid therapy with reduction in heart rate by 60% of baseline.

Keywords

Low-dose steroidswarm idiopathic autoimmune haemolytic anaemiasinus bradyarrhythmiahypokalaemia
Type
Brief Report
Information
Cardiology in the Young , Volume 31 , Issue 4 , April 2021 , pp. 651 - 653
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Miura, M, Ohki, H, Yoshiba, S, et al. Adverse effects of methylprednisolone pulse therapy in refractory Kawasaki disease. Arch Dis Child 2005; 90: 1096–1097.CrossRefGoogle ScholarPubMed
Stroeder, J, Evans, C, Mansell, H. Corticosteroid-induced bradycardia: case report and review of the literature. Can Pharm J (Ott) 2015; 148: 235–240.CrossRefGoogle ScholarPubMed
Al Shibli, A, Al Attrach, I, Hamdan, MA. Bradycardia following oral corticosteroid use: case report and literature review. Arab J Nephrol Transplant 2012; 5: 47–49.Google ScholarPubMed
Nagakura, A, Morikawa, Y, Sakakibara, H, Miura, M. Bradycardia associated with prednisolone in children with severe Kawasaki disease. J Pediatr 2017; 185: 106–111.CrossRefGoogle ScholarPubMed
Akikusa, J, Feldman, B, Gross, G, et al. Sinus bradycardia after intravenous pulse methylprednisolone. Am Acad Ped 2007; 119: 778–782.Google ScholarPubMed
Ohshima, M, Kawahata, K, Kanda, H, Yamamoto, K. Sinus Bradycardia after intravenous pulse methylprednisolone therapy in patients with systemic lupus erythematosus. Mod Rheumatol 2017; 1: 1–4.Google Scholar
Soni, R, Kumar, R, Debnath, J. Hydrocortisone induce bradyarrhythmias: a case report. Int Sci Rep 2017; 3: 13–14.CrossRefGoogle Scholar
Taylor, MR, Gaco, D. Symptomatic sinus bradycardia after a treatment course of high-dose oral prednisone. J Emerg Med 2013; 45: e55–e58.CrossRefGoogle ScholarPubMed
Perazella, MA, Rastegar, M. Disorders of potassium homeostasis. In: Reilly, RF, Perazella, MA (eds). Nephrology in 30 days, 2nd edn. McGraw Hill, New York, NY, USA, 2013: 71–88.Google Scholar