The odds of developing heart damage in children with Kawasaki’s disease are reduced to a significant extent when steroids are added to the standard treatment.

The finding was revealed during a study in an issue of Pediatrics and highlights a gap in knowledge. It was emphasized by this study that the benefits of steroid treatment for Kawasaki’s disease are good enough to provide relief to the children with this complication.

From News-Medical.Net:

Current guidelines from the American Academy of Pediatrics state that the evidence for steroid treatment is lacking and recommend the standard treatment for Kawasaki’s, which is aspirin and intravenous immunoglobulin (IVIG).

“This gap in knowledge led us to examine the benefits of steroids more closely. We looked at research worldwide and were surprised to find eight solid clinical trials showing the value of steroids in significantly reducing heart damage in children with Kawasaki’s disease. Steroids, when combined with aspirin and IVGB, reduced the odds of developing inflammation of the heart blood vessels by half,” said Stephen Aronoff, MD, lead author of the meta-analysis and Temple University School of Medicine professor and chair of pediatrics.

Kawasaki’s disease is one of the leading causes of acquired heart disease in children. The complication is treatable and the symptoms are red eyes, palms and foot soles, and swollen lymph nodes.

Children administered with steroids to treat chicken pox are at a higher risk of a more severe case of the virus leading to death.

The finding was revealed by pediatric oncologists at the Brenner Children’s Hospital, part of Wake Forest University Baptist Medical Center.

From News-Medical.Net:

“Steroids are used to treat leukemia and they suppress the immune system,” said Thomas McLean, a pediatric oncologist at Brenner Children’s Hospital. “When a child is exposed to the varicella virus (the virus that causes chicken pox) around the time they are receiving steroid treatment, they are more likely to contract a more severe case of chicken pox.”

McLean and his colleagues studied 697 patients with acute leukemia over a nine-year period. About 16 percent or 110 patients contracted chicken pox. Of those 110 patients, 54 had severe disease, including two deaths. Of the patients whose chicken pox was diagnosed within three weeks of taking steroids, 70 percent had severe infection whereas only 44 percent of those who had not received steroid therapy within three weeks had severe infection. Although the study was limited to patients with leukemia, the findings may apply to other conditions for which steroids are used, McLean said.

“One of the things we need to remember to ask before we prescribe steroid treatment is whether the child has had a recent exposure to chicken pox,” McLean said. “If so, we recommend waiting until the incubation period has passed before beginning steroid therapy.”

It was noted that chicken pox, though mild in nature, can result in fatal complications. It is worth noting here that there were approximately 12,000 deaths from chicken pox on a yearly basis before the discovery of varicella vaccine.

Some women who have been witnessed failed IVF treatments or suffering from repeated miscarriages can get benefit from steroid treatment. These facts were revealed during a conference in Liverpool in the United Kingdom.

Dr. Siobhan Quenby, of the University of Liverpool and the Liverpool Women’s Hospital, said that it was found during a recent study that three quarters of women who previously failed to conceive get benefited from steroid treatment.

From News-Medical.Net:

Dr. Siobhan Quenby, of the University of Liverpool and the Liverpool Women’s Hospital, says that tests involving 120 women had identified natural killer cells as a cause of miscarriages and failed IVF embryo implants.

While such natural but potentially deadly cells are beneficial in most of the body because they can destroy infected or malignant cells, in the uterus they have been found to promote rapid growth of blood vessels when present in high numbers.

These blood vessels then transport additional oxygen-bearing blood which can cause miscarriages or prevent embryos implanting.

Steroids prescribed to 40 women, who had suffered multiple miscarriages, resulted in three quarters of them successfully giving birth.

The steroid treatment has been shown to reduce the level of natural killer cells in the uterus, and this is thought to increase the chances of an embryo going to full term.

Dr. Quenby says currently there is no treatment for the thousands of women around the world who are desperate because they keep miscarrying for no reason.

She says there is a massive and desperate need for a treatment and suggests that a third of miscarriages could be prevented.

It was also suggested that steroid treatment is beneficial even for reducing the level of natural killer cells in the uterus with an aim to enhance the chances of an embryo going to the full term.

As per a recently concluded study, it was revealed that children being administered with inhaled corticosteroids such as budesonide in the past have not been able to show those improvements after stopping the steroid treatment. These results were observed after the Childhood Asthma Management Program (CAMP) clinical trial announced its findings on more than 1,000 children in the age group of 5-12 years.

During the study, it was found that children (now in their late teens) who have been advised steroid therapy in the past and stopped now showed no differences in management of asthma when they were compared with children who received the placebo.

Robert C. Strunk, M.D., a Washington University pediatrician at St. Louis Children’s Hospital and lead author of the study, said that it was quite interesting to note that children tend to do better with the passe of age when it comes to combating asthma.

Inhaled corticosteroids such as budesonide have been regarded as one of the most effective forms of anti-inflammatory treatments for controlling asthma via improving pulmonary function.

From Sciencedaily.com:

“While the kids did get better with age and didn’t seem to need the medicine as much, laboratory measurements indicated that they were still having symptoms, and therefore were primed to an attack if they got a bad cold or were exposed to a significant weather change,” Strunk said.

The researchers determined that continued benefit of these medications likely requires continued use.

“The conclusion is that some kids get better, but the doctor, family and the patient have to pay attention to the symptoms,” Strunk said. “Some of the kids are going to need medicine, and they have to be honest about that possibility.”

In another part of the follow-up study, researchers looked at long-term side effects of the steroid medications on growth, bone density and fracture rate. The only side effect of budesonide was a 0.4-inch decrease in height among female patients compared to the patients who took a placebo during the trial. However, one-fourth of the girls and more than half of the boys in the trial had not reached final adult height at the end of the post-trial period, researchers said. There were no effects of the nedocromil treatment on growth.

Funding from the National Heart, Lung, and Blood Institute and the National Center for Research Resources supported this research.

The study also suggested that if an asthma patient gets cured after being administered with steroid treatment then he should not stop the treatment presuming that asthma is completely cured. It was found that continued benefits of steroid medications require continued usage.