"The Effects of Short Course of Systemic Corticosteroids Treatment in Wheezy Children"

Background: The risk and benefits of long-term usage of systemic glucocorticosteroids (GCS) is widely analised. The short-term effects of systemic GCS still remain unclear.

Aim and objective: to analize the efects of short-term usage of systemic GCS on variation of blood cells count, biohemistry results and cortisol levels in children with acute wheezing.

Methods: Participants of prospective study were 44 wheezy children (average age-2,82 y/o; 3 months – 17 y/o) treated at LUHSH Kauno Klinikos Pediatric Clinic. Intervention group – 26 children who received systemic GSC (methylprednisolone or prednisolone), control group – 18 children without GCS. Full blood count, biochemistry tests (Na, K, glucose) and cortisol level in blood of all patients were analized. Tests were performed on the 1st, 2nd and 4th days of treatment. On the 1st day blood was taken before systemic GCS and any time of the day at the admittance. On other days – early in the morning. Results between 1st and 2nd day, and between 1st and 4th day were evaluated and compared. SPSS 23.0 statistics pack was used for data analysis.

Results: An average dose of methylprednisolone was 1,2 (0,4-2) mg/kg, duration of usage - 4,4 (1-15) d. Short-term usage of systemic GCS increased sodium concentration (p=0,014), decreased cortisol level (r=0,252; p=0,081), the count of leukocytes (p=0,043), neutrophils (p=0,045), and eosinophils (p<0,001) in the blood plasma. Systemic GCS caused the major reducion of eosinophils count in allergic children (p=0,023). The higher age of the child was the risk factor for cortisol supression after four days of using systemic GCS (r=-0,403; p=0,007).

Conclusion: The short-term usage of systemic GCS in wheezy children can reduce eosinophil‘s count in allergic patients as well as to decrease cortisol level especially in older children. Other minor effects on the level of sodium, leucocytes and neutrophils could be registred.