Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0338671 (Steroids)
 9,479 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

HIV-related chronic ITP is caused by an accelerated platelet destruction due to adsorption of circulating immune complexes and to specific anti-platelet antibodies, but perhaps also by a defective thrombopoiesis resulting from invasion of the megakaryocytes by the retrovirus. Treatment is needed when platelet numbers drop beneath 20.10(9)/L or when severe bleeding symptoms occur. Steroids, commercially available immunoglobulins for IV use, AZT and anti-Rh immunoglobulins can be administered, although relapses are frequent after withdrawal of the drugs. Recurrences after splenectomy are far less common, but the progression towards AIDS might be accelerated.
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PMID:HIV-related thrombocytopenia. 132 36

About 5-10% of HIV seropositive individuals, in all risk groups, develop a syndrome of immunological thrombocytopenic purpura (ITP). Despite the clear association between HIV infection and thrombocytopenia, the exact immune mechanism leading to the peripheral platelet destruction remains unclear. Whereas some data support the direct effect of autoantibodies to platelet constituents, other findings argue in favour of the deposition of immune complexes containing anti-HIV antibodies. Although viral components could not be detected in the immune complexes or on the platelet membrane, megakaryocytes were shown to contain viral RNA and there is some evidence for a direct or indirect role of HIV in the pathophysiology of this disorder. Steroids, intravenous high dose polyvalent immunoglobulin, anti-rhesus immunoglobulin, danazol and vincristine usually induce only a transient increase in platelet counts. Zidovudine was shown to provide a sustained response in 40-60% of the patients and appears to be the treatment of choice for HIV-related thrombocytopenia. Splenectomy has been effective in many cases with persistent, profound and symptomatic thrombocytopenia and, on a 4-year follow-up, does not influence the progression rate to AIDS or survival. Patients with thrombocytopenia are not at greater risk for the development of AIDS than seropositive non-thrombocytopenic patients. Thus, thrombocytopenia should not be viewed as a stage in the progression from asymptomatic infection to AIDS.
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PMID:HIV-related thrombocytopenia. 215 Mar 12

The clinician with interest in neuromuscular disease must become familiar with the clinical manifestations of HIV infection. It is important to realize that not everyone who is infected with HIV will develop clinical AIDS. This includes patients with clinical manifestations related to HIV infection, for example, neuropathy. Thus, if treatment is successful, patients can continue a normal life. HIV infection should be considered in almost any neuromuscular syndrome, especially neuropathies with features of demyelination, which may be the first manifestation of HIV infection. Plasmapheresis may be the treatment of choice for these disorders. Steroids should be used with caution. AZT seems to be a promising new agent to combat AIDS.
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PMID:Disorders of peripheral nerves associated with HIV infection. 215 12

Steroids have been a cornerstone in renal transplant immunosuppression. New immunosuppressive drugs have led to protocols using early steroid withdrawal or complete avoidance. A prospective protocol in 23 pediatric renal transplant (ages 2-14 yr) who received decreasing steroid doses stopping at day 7 post-Tx, FK, and MMF were compared with a CsA, AZT, historically matched steroid-based control group. Basiliximab was used in two doses. Anthropometric, biochemical variables, AR rates, and CMV infection were evaluated and compared using Student's t-test and regression analysis. A better growth pattern was seen in steroid withdrawal group. GFR rate and serum glucose were similar in both groups. Total serum cholesterol levels were significantly lower in steroid withdrawal group. The incidence of AR at 12 months was 4.3% in steroid withdrawal group vs. 8.6% in steroid-based group (p = ns). No difference in CMV infection was observed. Hemoglobin levels were low during the first months in both groups; reached normal values after six months. SBP became higher at 12 months in steroid-based group. Patient and graft survival was 98% in both groups at one-yr post-transplant. Early steroid withdrawal was efficacious, safe, and did not increase risk of rejection, preserving optimal growth, renal function, and reducing cardiovascular risk factors.
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PMID:Early steroid withdrawal in pediatric renal transplant on newer immunosuppressive drugs. 1791 Jun 51