Assessment of Behavior Abnormalities of Corticosteroids in Children with Nephrotic Syndrome

Introduction. The objective of this work was to define the frequency and severity of steroid related behavioral side effects in children with steroid sensitive idiopathic nephrotic syndrome (SSNS) during Treatment for relapse. Methods. 30 pediatric patients with steroid sensitive nephrotic syndrome were studied; known as SSNS at complete remission or low dose of Prednisolone and have relapse on follow up. All children in this study were subjected to full history taking, thorough clinical examination, assessment socioeconomic standard, and assessment of pediatric quality of life, a battery of psychometric tests included pediatric anxiety, depression, and aggression scores. Results. Our results revealed that there are highly significant increase in the mean values of anxiety, depression and aggression among cases starts to appear on week one and extends to three, five and seven weeks compared to baseline. In the seventh week of follow up cases show significant positive correlation between prednisone doses and mean values of anxiety and depression scores and aggression. Conclusion. we concluded that all studied children with SSNS often experience significant problems with anxiety, depression, and increased aggression during high dose steroid therapy. 1. Introduction Since Edward Kendall isolated cortisone in the late 1930 and Philip Hench first used it to treat rheumatoid arthritis in 1948. Corticosteroids have become the corner stone of therapy for many neurologic, respiratory, gastrointestinal, renal, endocrine, hematologic, neoplastic, rheumatologic, dermatologic, ophthalmic, and allergic conditions. More than 10 million new corticosteroid prescriptions are filled each year, up to 0.9% of the general population and as many as 7% of hospitalized patients receiving oral corticosteroid therapy at any given point [1]. Although a powerful therapeutic option, corticosteroids are associated with serious adverse effects, both physiologic and psychiatric. While the somatic adverse effects of corticosteroid therapy have been extensively researched and widely described, the neuropsychiatric adverse effects have received less attention. Moreover, the etiology and pathogenesis of these brain effects remain poorly understood The neuropsychiatric adverse effects of corticosteroids are complex, unpredictable, and often severe, ranging across most categories of psychopathology Mood liability, anxiety symptoms, cognitive impairments, behavioral disturbances, or psychotic features can present alone or in combination [2]. The aim of this study is to evaluate the