Background: Idiopathic thrombocytopenic purpura (ITP) is a rare and autoimmune disorder determined by an abnormal reduction in the number of platelets. The current study aims to evaluate the oxidative stress status of children with ITP in two treatment methods using METHYLPREDNISOLONE and METHYLPREDNISOLONE with intravenous immunoglobulin (IVIG). Materials and Methods: This retrospective study was conducted on 60 children with ITP who referred to Baghaei Hospital in Ahvaz in 2021.  All the ITP children were equally divided into two groups, 30 receiving METHYLPREDNISOLONE and 30 receiving METHYLPREDNISOLONE and IVIG. The sampling of the patients’ blood was done in two stages before and after the start of treatment. Then, malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant status (TAS), total oxidative status (TOS), catalase (CAT) and glutathione were measured according to the instructions in the commercial kit. The analyses were performed using SPSS software version 23. P value < 0.05 was significant. Results: The number of platelets after treatment in METHYLPREDNISOLONE and METHYLPREDNISOLONE+ IVIG groups was 133.44 ± 18.93 and 158.76 ± 34.76 (×103/µL), respectively. Itas significantly increased compared to that before the treatment (P = 0.04). The amount of TAC in the group receiving METHYLPREDNISOLONE + IVIG and the METHYLPREDNISOLONE group was 1.64 ± 0.18 and 1.26 ± 0.53 nm, respectively; there was a remarkable difference between the two groups (P = 0.001). Also, SOD, CAT and glutathione in the METHYLPREDNISOLONE + IVIG group were remarkably higher than those in the METHYLPREDNISOLONE group (P < 0.05). Finally, the levels of TOS were lower in the METHYLPREDNISOLONE + IVIG group (19.74 ± 9.93 μmol) than in the METHYLPREDNISOLONE group (26.65 ± 10.64 μmol) (P = 0.01). Conclusion: A combination of IVIG and METHYLPREDNISOLONE was found to have a greater effect on improving antioxidant status and decreasing the oxidative stress indices of ITP children.

Background: Although corticosteroids have dramatically altered the prognosis of patients with pemphigus vulgaris, morbidity and mortality from systemic corticosteroid side-effects remains high. High-dose intravenous METHYLPREDNISOLONE has been used successfully in blistering diseases to avoid the complications of long-term orally-administered glucocorticoids. The objective of this study was to compare the effectiveness and side-effects of oral and pulse steroid therapy in the treatment of pemphigus vulgaris.Methods: One hundred and twenty-three patients with pemphigus vulgaris were categorized into two groups of study and control according to the disease severity and patient’s preferred method of treatment. The study group included 36 males and 36 females. The control group included 26 males and 25 females. The mean±SD age of the two groups was 42.6±11.9 and 46.9±12.8 years, respectively. The mean±SD duration of the disease was 6.8±1.1 months in new cases (n=45) and 25.9±26.0 months overally in the study group; it was 7.2±1.8 months in new cases (n=30) and 28.4±24.6 months overally in the control group. During the induction phase, we performed pulse therapy with METHYLPREDNISOLONE in three consecutive monthly courses. Each course included 1000 mg intravenous METHYLPREDNISOLONE for 4 days plus 500 mg intravenous cyclophosphamide for 1 day. In this phase, the control group received 1–2 mg/kg/day oral prednisolone for 28 days plus 1.5 mg/kg/day azathioprine. All patients were followed for at least 12 months during which period, clinical response, relapse rate, and side-effects were evaluated.Results: Pulse intravenous METHYLPREDNISOLONE with cyclophosphamide was generally safe and well-tolerated. Therapeutic responses of skin and mucosal lesions, rates of complete remission and relapse, and major organ-specific complications were similar in both groups. Significant statistical differences existed in total orally-administered prednisolone in one year, admission duration, and annual weight increments between the two groups (P<0.05).Conclusion: Considering the side-effects of long-term oral steroids, hazards of obesity, and complications of long-term hospitalization, pulse METHYLPREDNISOLONE could be considered in patients who have problems with long-term admissions or with high-dose oral steroid usage, and also in obese patients.  

Introduction: In spite of various methods available for treatment of Alopecia Areata, treatment of diffuse Alopecia Areata is still a difficult problem. Although systemic corticosteroids are frequently effective but long term consumption of oral steroids is not recommended because of complications.Objective: To determine response to treatment and relapse in patients with diffuse Alopecia Areata. Materials and methods: In this interventive and quazi- experimental we studied 26 patients with Alopecia Areata (first attack or relapse in the current year). Intravenous METHYLPREDNISOLONE, 500mg, was prescribed for 3 successive days and the patients were examined in the months of 1,3, 6 and 12. Photographs of scalp were taken at each visit.Results: Results were registered in the forms prepared for each patient and analyzed statistically (Fisher test). Of a total of 17 patients with multifocal Alopecia Areata, 53%, 76.5%, 76.5% and 64.6% showed response to treatment at 1,3,6 and 12 months respectively. Relapse occurred 17.5%, 23.5% and 35% in the months 3,6,12 respectively. From the 7 patients with Alopecia Universalis, only one patient showed response. In two patients with Ophiasis (one case) and Totalis (one case), no response to treatment was seen. Conclusion: All responses to treatment were obtained in the patients with diffuse muttifocal Alopecia Areata. There was no statistically significant difference between response to treatment and relapse in patients with first attack and repeated attacks.

Intravenous glucocomcoid pulse therapy is a common treatment for immunologically origin diseases but it cannot be considered a completely benign treatment. The effects of long term administration of glucocorticoids on calcium and phosphorus metabolism are well known, but less is known about the effect of pulse therapy. The purpose of this study was to investigate the effect of METHYLPREDNISOLONE pulse therapy on serum and uninary calcium and phosphorus and serum parathormone. In this prospective study 40 patients who received METHYLPREDNISOLONE pulse therapy for different reasons were investigated. Patients with renal insufficiency and those taking medications affecting calcium and phosphorus metabolism were excluded. Serum calcium, phosphorus, parathormone, creatininand urinary calcium, phosphous, and creatinine were measured before pulse therapy and in three consecutive days after treatment. This intervention had no effect on serum calcium, parathonnone and urinary calcium. Serum phosphorus decreased with a nadir on the second day and urinary phosphous increased. It was concluded that glucocorticoid pulse therapy directly increases renal phosphorus excretion, but calcium metabolism is not disturbed.

We are presenting a case illustrating atrial fibrillation (AF) following the use of METHYLPREDNISOLONE in a patient with pelvic and femur fracture. A48- year- old man with no significant past medical history, was admitted to the emergency department after injury in a car accident. He suffered a multiple bone fracture with chief complaints of pain and shortness of breath. He was transferred to the ICU. To prevent fat embolism syndrome, he was treated with METHYLPREDNISOLONE 500 mg every 6 h. About 4 h after the second dose, his normal sinus rhythm changed to a sinus tachycardia and then to AF. The METHYLPREDNISOLONE therapy was discontinued. After about 8 h of METHYLPREDNISOLONE discontinuation, the patient's normal sinus rhythm returned. Corticosteroids have been utilized for prevention and treatment of fat embolism syndrome, although there is uncertainty about their effectiveness. Cardiac dysrhythmias have been reported following the use of METHYLPREDNISOLONE. One possible mechanism of METHYLPREDNISOLONE induced AF is the direct effect on cell membrane, resulting in potassium efflux, which in turn, may initiate cardiac dysrhythmias. Previous METHYLPREDNISOLONE-associated AF case reports suggest a higher chance of AF occurrence with higher dose of METHYLPREDNISOLONE. Corticosteroids should be used with caution, especially when high doses are indicated and in patients with high risk for arrhythmias.

Alopecia areata is a common coetaneous disease that it is pathogenesis is still obscure, although most authors tend to classify it as an autoimmune disease there hasn't been any effective treatment for extensive disease.This clinical trial study was performed in Zahedan during 2000-2001, 44 patients were included in this study and treated with iv-pulse methylptrednisolome or with ordeal prednisolone. The inclusion criteria for patients were at least 30% scalp hairless with inset fewer than one year before the study, not using any medication and not having any contraindication for corticosteroids. The patients randomly were selected and divided into two groups. One group received plus Methylpredinisolone and the other group conventional treatment.Of 39 patients who completed the study, 22 were given iv-plus of Methylpredinisolone 11 and were cured. OF 17 patients who were given oral pednisolone, only 4 of them were cured.This result indicates no significant difference between the 2 groups (X^2-P≥0.05) but according to Cocharns test with P<0.0003, there may be a better result for hair growth with the duration of time.Regarding the results, it is suggested that for treatment of Alpoecia areata with plus therapy with spending more time efficacy may be better and relapse is fewer.