Corticosteroid treatment myasthenia gravis

Guidelines from the American College of Rheumatology conditionally recommend the use of intra-articular corticosteroid injections for treatment of knee osteoarthritis. 51 The duration of pain relief is one to two weeks in most trials, with a few showing improvements lasting three to four weeks. 60 – 63 Research uniformly supports the safety of intra-articular corticosteroid injections for treatment of knee osteoarthritis; however, these studies are limited by lack of histologic data and poor long-term follow-up. 64 A Cochrane review found weak evidence for the use of corticosteroid injections for the treatment of knee rheumatoid arthritis. 52

Methotrexate is given weekly as an intramuscular injection of 15 to 25 mg. Side effects are rare and include leukopenia and hypersensitivity interstitial pneumonitis. Hepatic fibrosis is the most severe potential sequela of long-term therapy. Patients with concomitant alcohol abuse and/or morbid obesity are more likely to develop hepatic fibrosis and therefore should not be treated with methotrexate. It is prudent to obtain a baseline chest radiograph and to monitor complete blood count, liver function and renal function every two weeks until the patient is receiving oral therapy, and every one to three months thereafter. Before methotrexate therapy is initiated, the risks of treatment and the possible need for a liver biopsy should be discussed with the patient.

Allergic sensitivity to a topical corticosteroid is usually only picked up when an eczematous dermatitis being treated by a topical corticosteroid fails to respond to treatment or worsens. In cases of persistent or exacerbating dermatitis treated with corticosteroid preparations, corticosteroid sensitivity should be considered. However, it may also be due to irritation from or allergy to other components of the preparation such as preservatives . Lanolin , ethylenediamine , quaternium-15 and the antibacterial agent neomycin , are all known to be potent sensitisers.

Corticosteroid treatment myasthenia gravis

corticosteroid treatment myasthenia gravis

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