الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 115 |  |  |
| | | from | 115 | | |
Abstract
High-dose methylprednisolone pulse therapy has been used for a very long time and is generally considered safe (Baethge, et al., 1992), with a limited reported incidence of minor adverse effects varying between 0% and 56% in different series, with more intense and prolonged MPT resulting in higher toxicity (Wollheim, 1984). In a study using MPT for rheumatoid arthritis, no significant side effects were noted (Liebling, et al., 1981). Serious cardiovascular side effects are very rare (Bocanegra, et al., 1981), and several studies have concluded this.
Our study included 50 consecutive patients, were admitted in the Rheumatology and Critical care departments at Cairo University Hospital during the period from July 2008 to March 2009.
Inclusion criteria:
Patients treated with pulse methylprednisolone therapy for vanous indications, most of our cases were SLE patients
Exclusion criteria:
Previous history suggestive of: 1. Angina pectoris.
2. Myocardial infarction. 3. Palpitation and syncope.
All patients in our study underwent baseline clinical examination and investigations including:
• Medical history taking.
• Physical examination.
• Laboratory investigations.
• 12 lead ECG.
• Echocardiography.
• Holter ECG monitoring
Holter ECG monitoring was started 2 hours before MPT and continued after the therapy with a total period 24 hours.
Our results clarified that there were only five patients that suffered attacks of arrhythmia three patients suffered from PVCs, one patient suffered from PACs and one patient suffered from SVT.
When classifying the studied group into those suffered attacks of arrhythmia and those who did not; no statistically significant difference had been observed between the studied parameters and the occurrence of arrhythmia.
We concludeed that although reports of cardiac arrhythmias are rare and sporadic, yet these complication when searched for with patients consistently monitored they could be documented and diagnosed.
Recommendation
Large studies could have significant impact in suggesting a mechanism of such arrhythmias and answering the question whether these patients should be monitored during MPT or not.