Intractable epistaxis and systemic lupus: High-dose intravenous pulse steroids
| Autor: | Ryan Winters, Michael S. Ellis, Emily A. Waselchuk, Douglas M. Hildrew |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Dexamethasone Refractory medicine Humans Lupus Erythematosus Systemic In patient Disease process Glucocorticoids Systemic lupus business.industry Treatment options Middle Aged medicine.disease Dermatology Surgery Epistaxis Otorhinolaryngology Pulse Therapy Drug Injections Intravenous Female Vasculitis business Follow-Up Studies medicine.drug |
| Zdroj: | American Journal of Otolaryngology. 35:236-238 |
| ISSN: | 0196-0709 |
| DOI: | 10.1016/j.amjoto.2013.12.003 |
| Popis: | Importance Epistaxis is most commonly an easily treated ENT entity with a relatively simple algorithm. Occasionally, however, it is encountered as a devastating disease process that can humble the otolaryngologist. In the setting of comorbidities that exacerbate bleeding, in this case vasculitis due to systemic lupus erythematosus (SLE), epistaxis can be life-threatening and refractory to conservative management. Observations This case report describes the hospital course of a patient with severe SLE and intractable epistaxis. We discuss classic management options for epistaxis and offer a novel treatment option for patients with SLE-related vasculitides—goal-directed medical therapy with high-dose intravenous pulse steroid therapy. Conclusions and Relevance To our knowledge, this report not only is the first description of targeted treatment options for intractable epistaxis in patients with SLE, but also serves to augment the traditional algorithm with the addition of a goal-directed medical therapy—control of epistaxis through high-dose intravenous pulse steroid therapy. We demonstrated that 6 mg of intravenous dexamethasone given every 6 hours can be highly effective in controlling epistaxis in patients with uncontrolled SLE. The presumed mechanism is through control of associated vasculitides. |
| Databáze: | OpenAIRE |
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