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大剂量甲泼尼龙给药后皮质类固醇诱导的心动过缓:一例报告

Corticosteroid-induced bradycardia following high-dose methylprednisolone administration: a case report.

作者信息

Zkib Jwil, Sattout Raneem, Faour Sabah, Haddad Sultaneh, Bassut Ranim, Swed Wajd, Hritani Shahd, Mansouer Milad, Ghabally Mike

机构信息

Arab International University, Daraa, Syrian Arab Republic.

Faculty of Medicine, Aleppo University, Aleppo, Syrian Arab Republic.

出版信息

Ann Med Surg (Lond). 2024 Sep 10;86(10):6300-6302. doi: 10.1097/MS9.0000000000002530. eCollection 2024 Oct.

Abstract

INTRODUCTION

Besides their wide use in the clinical field due to their anti-inflammatory and immune-modulating effect, corticosteroids still have a lot of adverse effects. The most common adverse effects are hyperglycemia, hypertension, osteoporosis, psychosis, immunosuppression, weight gain, and hyperlipidemia. Another important side effect is cardiac arrhythmias.

CASE PRESENTATION

We report a case of a 43-year-old woman with multiple sclerosis who developed symptomatic bradycardia after 3 days of treatment with a high dose of methylprednisolone. The patient received a dose of atropine and her bradycardia resolved after 36 h of stopping methylprednisolone.

DISCUSSION

While tachyarrhythmias are more common, bradyarrhythmias such as bradycardia and premature atrial or ventricular contraction are rare but crucial to be considered.

CONCLUSION

Corticosteroid-induced bradycardia is usually in sinus rhythm and has an unknown etiology, possibly occurring at high and low doses. The majority of cases in the literature were asymptomatic and resolved spontaneously.

摘要

引言

皮质类固醇因其抗炎和免疫调节作用在临床领域广泛应用,但仍有许多不良反应。最常见的不良反应是高血糖、高血压、骨质疏松、精神病、免疫抑制、体重增加和高脂血症。另一个重要的副作用是心律失常。

病例报告

我们报告一例43岁的多发性硬化症女性患者,在接受高剂量甲泼尼龙治疗3天后出现症状性心动过缓。患者接受了一剂阿托品治疗,停用甲泼尼龙36小时后心动过缓得到缓解。

讨论

虽然快速心律失常更为常见,但心动过缓、房性或室性早搏等缓慢性心律失常很少见,但必须予以考虑。

结论

皮质类固醇诱发的心动过缓通常为窦性心律,病因不明,可能发生在高剂量和低剂量时。文献中的大多数病例无症状且可自发缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a10d/11444592/9c5572085c93/ms9-86-6300-g001.jpg

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