Steroid Side-Effects Short
If course longer than ... needs stress dose letter
NO live vaccines (MMR, VZV, rotavirus, yellow fever, BCG, typhoid) for at least 1 month post cessation of immunosuppression
Recommend all vaccines delayed by 3 months to get best response.
Indications:
Neurology: Transient myelitis, optic neuritis, refractory epilepsy, infantile spasms
NB see also steroids sideeffect, needs combining
Observation:
Arms
Legs
UA for glucose
Ix
BSL
I would advise the parents about
NO live vaccines (MMR, VZV, rotavirus, yellow fever, BCG, typhoid) for at least 1 month post cessation of immunosuppression
Recommend all vaccines delayed by 3 months to get best response.
Indications:
Neurology: Transient myelitis, optic neuritis, refractory epilepsy, infantile spasms
NB see also steroids sideeffect, needs combining
Observation:
- Short stature
- Weight gain (appetite stimulation)
- Pubertal delay (suppressed HP axis)
- Irritability
- Fat deposition: Buffalo hump, moon face, abdomen
- Skin
- atrophy
- Bruising
- Poor wound healing
Arms
- Finger pricks of BSL monitoring
- Hypertension
- Cataracts
- Tearing, Photophobia, Optic cupping see below (glaucoma)
- Oral thrush
Legs
- Oedema
UA for glucose
Ix
BSL
- hypoglycaemia (adrenal suppression)
- hyperglycaemia (thirst / polyuria)
- Na
I would advise the parents about
- Stress dose if sick/anaesthetic
- Immunosuppression
- Monitoring for polyuria, polydipsia, headache, sleep disturbance, nausea