Summary
Sudden death following steroid pulse therapy has been recently reported. Continuous electrocardiographic recording was performed 24 hours before, during, and 24 hours after each one to three high dose intravenous methyl prednisolone pulses administered of five patients with severe ankylosing spondylitis unresponsive to conventional therapy. No increase in supraventricular or ventricular arrythmias was observed. Bradiarrythmias, conduction disturbances or ischemic changes were not found. Cardiovascular symptoms did not occur in any case; there were no significative changes in any of the clinical controls. Transient elevations of serum glucose were observed in all patients. Although a transient increase in potassium and decrease in sodium urinary excretion was noted, serum levels remained within normal values.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mintz, G., Pulse methylprednisolone in ankylosing spondylitis. Arthritis Rheum, 1981, 24, 734. 736.
Richter, M., Woop, B., Panayi, G.S. Pulse methylprednisolone in ankylosing spondylitis. Arthritis Rheum, 1982, 25, S 13 (Suppl.)
Graham, D.C., Smythe, H.A. The carditis and aortitis of ankylosing spondylitis. Bull Rheum Dis, 1958, 9, 171.
Böttiger, L.E., Edhag, O. Heart block in ankylosing spondylitis and uropolyarthritis. Br Heart J, 1972, 34,5, 487–492.
Bergfeldt, L., Edhag, O., Vedin, L., Vallin, H. Ankylosing spondylitis: an important cause of severe disturbances of the cardiac conduction system. Am J Med, 1982, 73, 187–191.
Stubbs, S.S., Morrell, B.M. Intravenous methylprednisolone sodium succinate; adverse reactions reported in association with immunosuppressive therapy. Transplant Proc, 1973, 5, 1145–1146.
Garret, R., Paulus, H. Complications of intravenous methylprednisolone pulse therapy. Arthritis Rheum, 1980, 23, 677. (Abstract).
Bocanegra, T.S., Castaneda, M.D., Espinoza, L.R., Vasey, F.B. Germain, B.F. Sudden death after methylprednisolone pulse therapy. Ann Intern Med, 1981, 95, 122.
Moses, R.E., McCornick, A., Nickey, W. Fatal arrhythmia after methylprednisolone therapy. Ann Intern Med, 1981, 95, 781.
Lown, B., Calvert, A.F., Armington, R., Ryan, M. Monitoring for serious arrhythmias and high risk of sudden death. Circulation, 1975, 52 (Suppl. 3), 189–198.
Bennett, P.H., Burch, T.A. New York Symposium on Population Studies in the rheumatic diseases. Bull Rheum Dis, 1967, 17, 453–458.
The criteria committee of the New York Heart Association: Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. 7th. edition. Boston, Little, Brown and Company, 1973, 190–256.
Kennedy, H.L., Caralis, D.G. Ambulatory electrocardiography. A clinical perspective. Ann Intern Med, 1977, 87, 729–739.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nasswetter, G., Piñeiro, D.J., Morteo, O.M.G. et al. Holter monitoring in ankylosing spondylitis patients during methylprednisolone pulse therapy. Clin Rheumatol 3, 29–31 (1984). https://doi.org/10.1007/BF02715692
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02715692