| BRIEF REPORT |
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| Year : 2015 | Volume
: 1
| Issue : 1 | Page : 23-26 |
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Late onset bradycardia: An unusual Side-Effect of high dose dexamethasone pulse therapy in patients of pemphigus vulgaris: A case series of five patients
Shuken Dashore1, Sushil Pande1, Milind Borkar1, Abhishek Pande2
1 Department of Dermatology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
2 Department of Medicine, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
Correspondence Address:
Shuken Dashore
Department of Dermatology, NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/WKMP-0110.170754
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Introduction: High-dose corticosteroids are used for various autoimmune and inflammatory diseases. When supra-pharmacologic doses of corticosteroids are used intravenously for the treatment of immunobullous diseases such as pemphigus, it is likely to be associated with side effects such as electrolyte disturbances, hypertension, and psychosis. Case Reports: In these case series, we report five patients receiving high-dose of dexamethasone with or without cyclophosphamide pulse, developing an unusual form of late onset bradycardia. Details of these patients developing bradycardia after dexamethasone pulse therapy are presented here. In all of these cases, bradycardia can be attributed to high-dose intravenous dexamethasone therapy. Bradyarrhythmias and sinus bradycardia may occur as an adverse effect of pulse therapy. Conclusion: Late onset of bradycardia is usually delayed in comparison to steroid infusion and frequently not apparent even after the 3rd day. Bradycardia may be associated with dizziness and may lead to fall and unnecessary trauma. Dermatologists should be aware of this complication, and timely referral to physician is essential.
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