PMID- 34309317
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1668-3501 (Electronic)
IS  - 0325-0075 (Linking)
VI  - 119
IP  - 4
DP  - 2021 Aug
TI  - Corticosteroid-induced sinus bradycardia in a young boy with adrenal 
      insufficiency and sepsis.
PG  - e353-e356
LID - 10.5546/aap.2021.eng.e353 [doi]
AB  - The literature does not commonly describe cardiac rhythm disturbances, including 
      bradycardia, in patients who are receiving corticosteroids, and the exact 
      mechanism of such disturbances remains unknown. Herein, we present a case of 
      sinus bradycardia associated with stress-dose corticosteroid therapy. A 
      nine-year-old boy with a history of panhypopituitarism was admitted with 
      gastroenteritis and pneumonia and developed septic shock on the day of admission. 
      Management using intravenous fluids, stress doses of hydrocortisone, and 
      antibiotics resulted in full recovery. However, within 24 hours following 
      treatment, sinus bradycardia was documented, with a heart rate of 45 beats per 
      minute (BPM). The bradycardia resolved after the dose of hydrocortisone was 
      decreased gradually. Corticosteroidinduced sinus bradycardia is an adverse effect 
      that usually resolves after corticosteroid treatment is discontinued. During 
      stress-dose corticosteroid therapy, hemodynamic monitoring should be considered. 
      To our knowledge, this is the first report of sinus bradycardia following the use 
      of hydrocortisone in children who have adrenal insufficiency.
CI  - Sociedad Argentina de Pediatria.
FAU - Cimbek, Emine A
AU  - Cimbek EA
AD  - Karadeniz Technical University, Faculty of Medicine, Department of Pediatric 
      Endocrinology, Trabzon, Turkey.
FAU - Kaya, Gulay
AU  - Kaya G
AD  - Karadeniz Technical University, Faculty of Medicine, Division of Pediatrics, 
      Trabzon, Turkey.
FAU - Ozturk, Mehmet A
AU  - Ozturk MA
AD  - Istanbul University Cerrahpasa, Faculty of Medicine, Division of Pharmacology, 
      Istanbul, Turkey.
FAU - Dilber, Embiya
AU  - Dilber E
AD  - Karadeniz Technical University, Faculty of Medicine, Department of Pediatric 
      Cardiology, Trabzon, Turkey.
FAU - Karaguzel, Gulay
AU  - Karaguzel G
AD  - Karadeniz Technical University, Faculty of Medicine, Department of Pediatric 
      Endocrinology, Trabzon, Turkey.
LA  - eng
LA  - spa
PT  - Case Reports
TT  - Bradicardia sinusal inducida por corticoesteroides en un nino con insuficiencia 
      suprarrenal y septicemia.
PL  - Argentina
TA  - Arch Argent Pediatr
JT  - Archivos argentinos de pediatria
JID - 0372460
RN  - 0 (Adrenal Cortex Hormones)
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adrenal Cortex Hormones/adverse effects
MH  - *Adrenal Insufficiency/chemically induced
MH  - Bradycardia/chemically induced
MH  - Child
MH  - Humans
MH  - Hydrocortisone
MH  - Male
MH  - *Sepsis/complications/drug therapy
MH  - *Shock, Septic
OTO - NOTNLM
OT  - adrenal insufficiency
OT  - bradycardia
OT  - corticosteroid
COIS- None
EDAT- 2021/07/27 06:00
MHDA- 2021/10/16 06:00
CRDT- 2021/07/26 09:20
PHST- 2020/09/15 00:00 [received]
PHST- 2021/03/01 00:00 [accepted]
PHST- 2021/07/26 09:20 [entrez]
PHST- 2021/07/27 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
AID - 10.5546/aap.2021.eng.e353 [doi]
PST - ppublish
SO  - Arch Argent Pediatr. 2021 Aug;119(4):e353-e356. doi: 10.5546/aap.2021.eng.e353.