The effects of corticosteroids on behavior in children with nephrotic syndrome

Hall, Angela; Thorley, Geoffrey; Houtman, P

doi:10.1007/s00467-003-1295-x

Cited by 49 publications

(49 citation statements)

References 13 publications

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“…Patients prescribed exogenous steroids for autoimmune or antiinflammatory medical conditions report similar neuropsychiatric side effects, including irritability, fatigue, mood changes, insomnia, and difficulty with concentration and attention, 38,44,45 that typically resolve after discontinuation of glucocorticoid medication. However, because of the variability in underlying medical disease and amount and type of glucocorticoids used, it is difficult to make causal inferences.…”

Section: Discussionmentioning

confidence: 99%

Cases of Psychiatric Morbidity in Pediatric Patients After Remission of Cushing Syndrome

Keil

Zametkin²,

Ryder

et al. 2016

Pediatrics

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Endogenous Cushing syndrome (CS) may have different effects in children than what has been described in adults. Previous studies of children and adolescents with CS have identified cognitive decline despite reversal of brain atrophy after remission of CS. Although the observations of parents of children and adolescents with CS support personality changes, significant psychopathology has not been described in the literature. We report 9 children who underwent successful surgery (transsphenoidal surgery [TSS] or resection of bronchial carcinoid) for treatment of CS and subsequently developed significant affective pathology. Affective symptoms included anger–rage outbursts, suicidal ideation, irritability, anxiety, and depression. One child, who committed suicide 60 months after TSS, had recently discontinued antidepressant medication. She had a history of anxiety during active CS and was treated with an anxiolytic. The 7 patients with onset of symptoms within 7 months of TSS were on glucocorticoid replacement, and 1-year follow-up evaluation showed recovery of hypothalamic–pituitary–adrenal axis and biochemical evidence of remission. The 2 patients who presented with onset of symptoms at 48 months or later underwent endocrine evaluation that showed biochemical evidence of remission and normal anterior pituitary hormone levels. This is the first report of affective symptoms and behavioral dysregulation, including suicidal ideation, in a subgroup of children and adolescents after remission of CS. Health care providers caring for children with CS who have been cured should continue to screen for mental illness, monitor for changes in behavior, and refer as appropriate to mental health professionals.

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Section: Discussionmentioning

confidence: 99%

Cases of Psychiatric Morbidity in Pediatric Patients After Remission of Cushing Syndrome

Keil

Zametkin²,

Ryder

et al. 2016

Pediatrics

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“…In case series of children with such discrete conditions as asthma and nephrotic syndrome, up to 50% of those receiving oral glucocorticoids have had adverse behavioural and affective effects including elevated levels of depression and anxiety, as well as increases in insomnia (Estrada de la Riva, 1958;Bender et al, 1988;Hall et al, 2003).…”

Section: Steroidsmentioning

confidence: 99%

Drugs Inducing Insomnia as an Adverse Effect

Malangu¹

2012

Can't Sleep? Issues of Being an Insomniac

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“…Each relapse is treated with induction of remission with prednisolone 60mg/m 2 as a single daily dose until remission, followed by 40mg/m 2 / every other day for 28 days 11 . Frequent relapses and steroid dependency exposes these children to multiple courses of high-dose prednisolone placing them at risk of a plethora of significant corticosteroid related side-effects such as hypothalamus-pituitary-adrenal axis suppression, hypertension, Cushing syndrome, obesity, bone disease, growth retardation, posterior lenticular cataracts, pubertal delay and behavioural disturbances [12][13][14] .…”

Section: Introductionmentioning

confidence: 99%