Prednisone multiple sclerosis

Azathioprine and mercaptopurine appear to be of definite benefit in maintaining renal allografts and may be of value in transplantation of other tissues. These antimetabolites have been used with some success in the management of acute glomerulonephritis and in the renal component of systemic lupus erythematosus. They have also proved useful in some cases of rheumatoid arthritis, Crohn s disease, and multiple sclerosis. The drugs have been of occasional use in prednisone-resistant antibody-mediated idiopathic thrombocytopenic purpura and autoimmune hemolytic anemias. 

The effects of prednisone on memory have been assessed (SEDA-21, 413 90). Glucocorticoid-treated patients performed worse than controls in tests of explicit memory. Pulsed intravenous methylprednisolone (2.5 g over 5 days, 5 g over 7 days, or 10 g over 5 days) caused impaired memory in patients with relapsing-remitting multiple sclerosis, but this effect is reversible, according to the results of an Italian study (91). Compared with ten control patients, there was marked selective impairment of explicit memory in 14 patients with relapsing-remitting multiple sclerosis treated with pulsed intravenous methylprednisolone. However, this memory impairment completely resolved 60 days after methylprednisolone treatment. 

Minden SL, Orav J, Schildkraut JJ. Hypomanic reactions to ACTH and prednisone treatment for multiple sclerosis. Neurology 1988 38(10) 1631-4. 

The general toxicity of interferon beta is very similar to that of interferon alfa (2), with no apparent differences between the two recombinant preparations with any route of injection (SEDA-20, 332) (3-6). In multiple sclerosis, fatigue and a transient flu-like syndrome responsive to paracetamol or the combination of paracetamol plus prednisone have been observed in about 60% of patients during the first weeks of treatment, and tachyphylaxis usually developed after several doses (7). Patients with chronic progressive disease are more likely to discontinue treatment because of adverse effects (8). 

A 49-year-old man had a progressive unproductive cough and right hemithoracic pain after 3 months of interferon beta-la 30 micrograms/week for multiple sclerosis. A CT scan showed a right basal pulmonary infiltrate and transbronchial biopsies showed features consistent with bronchiolitis obliterans with organizing pneumonia. The lesions resolved fully on interferon beta-la withdrawal and prednisone treatment. 

An individual case of a 45-year-old female with multiple sclerosis who presented to the emergency department with symptomatic sinus bradycardia after the completion of a high-dose oral prednisone therapy for multiple sclerosis-related optic neuritis has been reported [6 ]. She received l,250mg of oral prednisone per day for 5days in total and finished her course 3 days before her emergency department presentation. The patient s pulse rate and symptoms resolved on their own a week after the completion of the high-dose prednisone. There are very few adult cases that report this side effect and all of them have been with intravenous methylprednisolone. This is the first case report of a patient with symptomatic bradycardia from an oral CS regimen. 

About 2 weeks after receiving a second dose of adsorbed tetanus toxoid a 50-year-old woman developed generalized morphea, a rare condition, in which multiple patches of skin sclerosis occur over much larger areas than in the localized variant. The patient denied taking any drugs. After prednisone therapy, a month later the lesions had dramatically improved (12). 

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