A Review On Adverse Effects Of Prolonged Steroid Use In Children

Abstract

This review provides an overview of the impact of long-term use of steroids. Steroids are natural substances with many different effects in the human body, which begin over several days, as even birth control pills are a form of steroids. Natural steroids can be used to increase certain enzymes which a person’s body may have trouble creating naturally, such as testosterone, which is vital in the growth and development. Although modern clinical management strategies have improved the outcome of paediatric patients with severe autoimmune and inflammatory diseases over recent decades, a proportion will experience ongoing or recurrent/relapsing disease activity despite multiple therapies often leading to irreversible organ damage, and compromised quality of life, growth/development and long-term survival. Several studies demonstrated that the use of alternate-day corticosteroid therapy maintains control of autoimmune diseases due to the prolongation of their therapeutic effect beyond their metabolic effect, with a significant decrease in side effects in patients. For this reason, the current recommendation for the use of these medications is in a short cycle to avoid adverse effects when used frequently and for prolonged periods of time. Patients on corticosteroid therapy, specially for a long period are likely to develop many adverse effects related to the therapy. The potency of dexamethasone and betamethasone in suppressing growth is nearly 18 times higher than that of prednisolone. There is some evidence that the administration of growth hormone can reverse these changes.