IV steroids and other

[rawksea76]

I am just wondering if anyone knows of any other autoimmune disease that will respond well to IV steroids?

I was on a 5 day round to stop a major flare before I was diagnosed. And do they help the inflamation that shows up on an MRI as for leisons???

[0485c10]

1...I am just wondering if anyone knows of any other autoimmune disease that will respond well to IV steroids?

I was on a 5 day round to stop a major flare before I was diagnosed. 2..And do they help the inflammation that shows up on an MRI as for lesions???

1. Too many to list. Do a search of inflammatory,auto immune disease--
arthritis, crohns, sarcoidosis,Lupus,

2. Yes steroids purposed is to reduce the inflammation that occurs when nerves are demyelinated, which is in the brain,optic nerve or spinal tract. I was diagnosed with lots of lesions in my brain & the first 2 MRI showed the swelling had gone down after steroids. There was less space left between my brain and my skull in the first MRI and more space between my brain and skull in the 2nd MRI after 3 years and steroids when my MS was not as active...

I researched that because I'm the type that does research everything I can think of. The soft part of a skull the baby is born with is to allow the skull to grow to the size of the brain..so there should not be that much space between the brain & the skull?

On the first MRI it must have been inflammation that reduced it more than in later MRI's ?
But I fear that the greater space on later MRI's if just brain atrophy

Sometimes I ask myself too many questions to investigate

Steroids do reduce inflammation and needing to reduce the inflammation in the brain & optic nerve is why high dose IV steroids are used in MS...

Although I have read there is absolutely no difference in final outcome of a relapse between oral steroids and IV steroids? EXCEPT in Optic neuritis In ON ---oral steroids treated relapses were found to re-occur more often than if IV steroids are used.

It was thought this might occur, because the ON lies entirely in the brain and may need the faster delivery system of steroid directly into the vein than the slower delivery system of oral steroids that need to go through the digestive system first.

A persons response to steroids is totally unique to the individual-one person may respond well to them and another person less well. And not only is it totally unique to every person, but each time its totally unique within every individual. One time it may work quickly and very effective in the person, with few side affects---another time many side affects, and a slower response in that same person? So the response is different for different people and different for each occurrence within the same person.

And response to steroids becomes less effective after repeated steroid use.

[CocoH]

I don't know about your first question. As far as how the steroids affect lesions.......what the steroids are supposed to do is remove the inflammation that makes them "active". The lesion itself will still be there.

[Redwings]

Virtually all autoimmune diseases -- and there are many -- respond to steroids. How well they respond depends on the condition and the individual. Even in the same person, steroids might not work the same way each time. So it can't be said that there's a disease that always responds well.

Steroids can reduce or stop inflammation, but they don't heal damage. Rather, they provide a quiet environment in which the body can heal by itself. The inflammation in lesions that show up on MRI can be helped by steroids, but the lesions still have to heal by themselves. Sometimes that happens fairly quickly, sometimes it takes months.

[Amy J]

As I understand it, steroids basically depress the immune response, which is why they're so effective in autoimmune diseases. Inflammation is one of the basic ways our bodies fight disease. With autoimmune diseases, inflammation serves to damage our own tissues. Steroids (which are really synthetic hormones) decreases inflammation.

HTH.

[Redwings]

In ON ---oral steroids treated relapses were found to re-occur more often than if IV steroids are used.

It was thought this might occur, because the ON lies entirely in the brain and may need the faster delivery system of steroid directly into the vein than the slower delivery system of oral steroids that need to go through the digestive system first.

At the time of the Optic Neuritis Treatment Trial (ONTT), it was customary that the term "oral steroids" inherently meant LOW dose and IV meant HIGH dose. In the ONTT, the oral dose used was only about 60 or 70 mg. The subjects on low dose orals were more likely to have a recurrence of ON than those treated wit high dose IV or not treated at all. So in the terminology that was customary at the time, the finding was that orals were contraindicated -- but it was because of the low dose (oral meant low dose), not because of the steroids were taken orally.

It has since been found that -- at equivalent dose -- oral steroids are as effective as IV. So it's becoming more common now for patients to take high dose oral prednisone to treat ON -- about 1200 mg oral prednisone is approximately equivalent to 1000 mg IVSM. (Actually, I just did it myself recently.)

The likelihood of recurrence of ON that was found with with orals in the ONTT had nothing to do with the steroids taking longer to get to the brain. In fact, the prechiasmal optic nerves are entirely outside and below the brain, so speed of getting steroids into the brain isn't an issue in ON.

The suspected problem with oral prednisone at the time of the ONTT was that the dose was too low to knock out the inflammation and it was more likely to recur. It's possible that if high dose orals were tested in the ONTT, the subjects on high dose orals wouldn't have shown the same propensity for relapse as the patients on low dose orals.

So it can no longer be said that oral prednisone is contraindicated for ON. That's old-think. It can only be said that low dose prednisone -- which is commonly administered orally -- is contraindicated. Oral prednisone is OK to use for ON if it's administered at high dose. The medical literature still uses the old terminology about "oral" prednisone being contraindicated, but with time the terminology will get updated.