High-dose intravenous methylprednisolone pulse therapy in systemic lupus erythematosus

Kimberly, Robert P.; Lockshin, Michael D.; Sherman, Raymond L.; McDougal, J. Steven; Inman, Robert D.; Christian, Charles L.

doi:10.1016/0002-9343(81)90538-6

Cited by 132 publications

(27 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After the report by Kountz and Cohn [7], who prescribed pulse therapy for acute rejec tion in renal transplantation, many clini cians attempted to treat severe immunolog ical disorders including rapidly progressive glomerulonephritis [2], lupus nephritis [6] and polyarteritis nodosa [10] with high-dose méthylprednisolone.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Methylprednisolone Pulse Therapy in Dermatomyositis

Yanagisawa¹,

Sueishi²,

Nawata³

et al. 1983

Dermatology

View full text Add to dashboard Cite

A high dose of methylprednisolone (pulse therapy) was given to 3 patients with uncontrolled dermatomyositis (DM) accompanied by severe muscle weakness. The effects of pulse therapy were compared with findings in 5 patients with severe DM who were treated with the usual dose of prednisolone (controls). The pulse therapy led to an improvement in the clinical symptoms in the 3 patients with uncontrolled DM, who were in danger of aspiration pneumonia. A rapid reduction in muscle enzyme levels in this group was also evident.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Following this report, this treat ment has been tried in patients with immu nological disorders such as rapidly progres sive glomerulonephritis [2], lupus nephritis [6] and polyarteritis nodosa [10],…”

mentioning

confidence: 99%

Methylprednisolone Pulse Therapy in Dermatomyositis

Yanagisawa¹,

Sueishi²,

Nawata³

et al. 1983

Dermatology

View full text Add to dashboard Cite

show abstract

“…In 2 experimental studies, IV méthylprednisolone has produced a marked reduction in crescent formation, intra-and extraglomerular mononuclear cells and protein uria accompanied by improved renal function, effects that were not seen with high dose oral prednisone [154,155]. Méthylprednisolone also increases renal plasma flow and filtration rate in most circumstances [156,157], but may inhibit prostaglandin synthesis [158] and thereby tran siently decrease glomerular filtration in patients with pros taglandin-dependent glomerular perfusion as suggested in systemic lupus erythematosus [159], …”

Section: Treatmentmentioning

confidence: 99%

Idiopathic Rapidly Progressive Glomerulonephritis

Couser

1982

Am J Nephrol

View full text Add to dashboard Cite

“…Third, the high dose of corticosteroid used by Nava et al 29 is massive by clinical standards, 4 and therefore it is unclear whether their findings can be generalized to the use of pulse-dose (i.e., 10 mg/kg/day) corticosteroids for treating clinical conditions such as lung transplant rejection 28 or autoimmune disease. 19 Finally, time-course effects of high-dose methylprednisolone on diaphragm muscle function are unknown but might prove informative in elucidating mechanisms responsible for the loss of diaphragmatic function with high-dose corticosteroids.…”

mentioning

confidence: 99%

Acute effects of high‐dose methylprednisolone on diaphragm muscle function

et al. 2008

View full text Add to dashboard Cite

The time- and dose-dependent effects of acute high-dose corticosteroids on the diaphragm muscle are poorly defined. This study aimed to examine in rabbits the temporal relationships and dose-response effects of acute high-dose methylprednisolone succinate on diaphragmatic contractile and structural properties. Animals were assigned to groups receiving: (1) 80 mg/kg/day methylprednisolone (MP80) intramuscularly for 1, 2, and 3 days; (2) 10 mg/kg/day methylprednisolone (MP10, pulse-dose) for 3 days; or (3) saline (placebo) for 3 days; and (4) a control group. Diaphragmatic in vitro force-frequency and force-velocity relationships, myosin heavy chain (MyHC) isoform protein and mRNA, insulin-like growth factor-1 (IGF-1), muscle atrophy F-box (MAF-box) mRNA, and volume density of abnormal myofibrils were measured at each time-point. MP80 did not affect animal nutritional state or fiber cross-sectional area as assessed in separate pair-fed groups receiving methylprednisolone or saline for 3 days. Compared with control values, MP80 decreased diaphragmatic maximum tetanic tension (Po) by 19%, 24%, and 34% after 1, 2, and 3 days (P < 0.05), respectively, whereas MP10 decreased Po modestly (12%; P > 0.05). Vmax and MyHC protein proportions were unchanged in both the MP80 and MP10 groups. Maximum power output decreased after 2 and 3 days of MP80. Suppression of IGF-1 and overexpression of MAF-box mRNA occurred in both MP groups. Significant myofibrillar disarray was also observed in both MP groups. The decline in Po was significantly associated with the increased volume density of abnormal myofibrils. Thus, very high-dose methylprednisolone (MP80) can produce rapid reductions in diaphragmatic function, whereas pulse-dose methylprednisolone (MP10) produces only modest functional loss.

show abstract

High-dose intravenous methylprednisolone pulse therapy in systemic lupus erythematosus

Cited by 132 publications

References 29 publications

Methylprednisolone Pulse Therapy in Dermatomyositis

Methylprednisolone Pulse Therapy in Dermatomyositis

Idiopathic Rapidly Progressive Glomerulonephritis

Acute effects of high‐dose methylprednisolone on diaphragm muscle function

Contact Info

Product

Resources

About