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Open Access Highly Accessed Review

A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy

Dora Liu1, Alexandra Ahmet2, Leanne Ward2, Preetha Krishnamoorthy3, Efrem D Mandelcorn4, Richard Leigh5, Jacques P Brown6, Albert Cohen7 and Harold Kim1089*

Author Affiliations

1 Division of Endocrinology and Metabolism, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada

2 University of Ottawa, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

3 McGill University, Montreal Children’s Hospital, Montreal, QC, Canada

4 Department of Ophthalmology and Vision Sciences, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, ON, Canada

5 Division of Respiratory Medicine, University of Calgary, Calgary, AB, Canada

6 Department of Medicine, Laval University, Quebec City, QC, Canada

7 McGill University, Jewish General Hospital, Montreal, QC, Canada

8 Western University, London, ON, Canada

9 McMaster University, Hamilton, ON, Canada

10 525 Belmont Ave West, Suite 205, Kitchener, ON N2M 5E2, Canada

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Allergy, Asthma & Clinical Immunology 2013, 9:30  doi:10.1186/1710-1492-9-30

Published: 15 August 2013

Abstract

Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular disease, Cushing’s syndrome, psychiatric disturbances and immunosuppression are among the more serious side effects noted with systemic corticosteroid therapy, particularly when used at high doses for prolonged periods. This comprehensive article reviews these adverse events and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors.

Keywords:
Adverse events; Adrenal suppression; Corticosteroids; Cushing’s syndrome; Hyperglycemia; Glaucoma; Glucocorticoids; Glucocorticoid-induced osteoporosis; Side effects; Systemic