Vasculitis steroid treatment


--- Stress is often mentioned by CSS patients around the time of their diagnosis, and in a way this seems related to the adrenal glands as well. A patient in another support group reported reading in "The Stress of Life" by Dr. H. Seyle:.... "the adrenal glands are the processors of stress in our bodies. A person's stress resistance will vary with the competence of his adrenals. Continually stressing them, finally depletes them. When we become exhausted by life, on a mental or physical level, our adrenal glands often fail to keep up, and illness ensues".

Unfortunately, most of the treatments for CSS have significant side effects. The key is to try and be maintained on as low a dose of medication as possible to avoid side effects. Many find they can be maintained on fairly low doses of steroids alone after the initial therapy. With any flares of disease a high dose of steroids will again be given and then tapered when symptoms improve. If steroids alone can control the disease they are often the best option. If you continue to have symptoms or “flare” then many times that is when an additional immunosuppressive drug is added. The nature of CSS tends to be one where symptoms go up and down, and you will find that your dosage of medications will also go up and down. It is our hope that more and more research will be done for CSS, and that new medications with fewer side effects will become available. There are a few promising studies researching new medications for CSS. One such study is on the anti-IL-5 drug. In the promising studies so far, it has shown to greatly reduce eosinophil counts and symptoms, with very few side effects. More research is needed and our organization is committed to supporting all research into CSS and the treatments of this disease.

Rheumatologists are usually the specialists with the most overall knowledge about vasculitis. Thus, they direct the care of patients, particularly those with chronic or severe disease. Patients with vasculitis often benefit from seeing experts in the organ systems that are or might become affected. Doctors that patients may need to see include a dermatologist (skin doctor), neurologist (expert in nervous system diseases), ophthalmologist (eye doctor), otorhinolaryngologist (ear, nose and throat doctor), nephrologist (kidney doctor) or pulmonologist (lung doctor).

The exact role of vascular imaging with respect to monitoring of disease activity and prediction of disease relapse has not clearly been defined in giant cell arteritis. For this reason, patients with giant cell arteritis who are enrolled in the GiACTA trial can participate in a positron emission tomography-computed tomography (PET/CT) substudy. Selected patients will undergo a PET/CT of the neck, chest, abdomen and pelvis after one year of treatment to scan the large arteries for radiographic evidence of vascular inflammation. The goal of this substudy is to determine the proportion of patients with radiographic activity and the correlation of radiographic findings with the risk of subsequent disease relapse.

If you’re feeling fearful or very stressed over your condition, it can be a good idea to speak with a professional counselor or therapist. This is especially important since stress can further weaken the immune system. Some people struggling with serious illnesses wind up feeling depressed and isolated. This can take a toll on a person’s well-being. It can make it even harder to overcome the condition. Try opening up to your family, friends and support network about your struggles. Or you may even want to find a support group online or in person. Consider asking your doctor to recommend a therapist who has experience working with people who are dealing with stressful health conditions.

Prednisone directly causes atrophy of muscle fibers (myopathy) leading to muscle weakness.  This is a very common side effect of chronic (a few months or more) prednisone use but can be either mild or severe.  Patients usually notice weakness most in the upper legs.  It is not a painful condition directly, but weak muscles and their tendons are more easily strained, which can lead to pain.  Muscle weakness that is so severe as to involve the muscles of breathing is rare, but leg weakness can lead to shortness of breath with climbing stairs.

Vasculitis steroid treatment

vasculitis steroid treatment

The exact role of vascular imaging with respect to monitoring of disease activity and prediction of disease relapse has not clearly been defined in giant cell arteritis. For this reason, patients with giant cell arteritis who are enrolled in the GiACTA trial can participate in a positron emission tomography-computed tomography (PET/CT) substudy. Selected patients will undergo a PET/CT of the neck, chest, abdomen and pelvis after one year of treatment to scan the large arteries for radiographic evidence of vascular inflammation. The goal of this substudy is to determine the proportion of patients with radiographic activity and the correlation of radiographic findings with the risk of subsequent disease relapse.

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