Muhammad Junaid Khan, Saima Gillani.
Corticosteroid Induced Generalized Seizures in a Nephrotic Child with Iatrogenic Cushing Syndrome.
Pak Paed J Jan ;42(2):135-9.

Nephrotic syndrome is the presence of nephrotic range proteinuria, hyperlipidemia, and hypoalbuminemia. It affects children 15 times more than adults. Steroids are the mainstay of initial therapy in pediatric nephrotic syndrome. Initially, it is usually continued for 4 to 6 weeks and once remission is induced, the dose is tapered gradually. In children, prolonged use of steroids should be cautious. Unfortunately, due to lack of proper counseling, primary unawareness and over the counter sales, many children diagnosed with nephrotic syndrome present with its serious adverse effects. Physicians rarely find the time to properly counsel the patients regarding therapy, side effects of medicines, and even the disease itself. We encountered a very rare case, a 10-year-old nephrotic female with iatrogenic Cushing syndrome. She was initially prescribed high dose oral corticosteroids. Later on, due to poor compliance and improper counseling, she developed iatrogenic Cushing syndrome and corticosteroid-induced generalized seizures. Nephrotic syndrome is commonly encountered in children so proper counseling should be made. It is important to pick up the complications as early as possible and then start appropriate treatment. Regular examinations and monitoring for chronic complications will improve outcomes for children with nephrotic syndrome otherwise prolong use can lead to serious complications. Furthermore, guidelines are required for management of prolonged (especially >2 weeks) use of corticosteroid.

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