{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T22:37:49Z","timestamp":1776379069608,"version":"3.51.2"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Corticosteroid\u2010induced psychosis is rare and less reported in children compared to adults. However, psychosis is considered a severe adverse effect of corticosteroids in pediatric nephrotic syndrome. Steroid\u2010induced psychosis is dose\u2010dependent and should be treated by tapering the dose of steroids and usually initiating an atypical antipsychotic. A 13\u2010year\u2010old male child presented to the pediatrics outpatient department with complaints of anxiety, fearfulness, and seeing images of an old man crawling into his room and threatening to strangle him with a red rope, which led to decreased sleep. He was initiated on oral prednisolone 3\u2009weeks ago after being diagnosed with nephrotic syndrome. A diagnosis of steroid\u2010induced psychosis was made, and he was tapered on steroids over 6\u2009weeks. He was then initiated on tacrolimus, quetiapine, and lorazepam and was discharged after a week. At follow\u2010up in 4\u2009weeks, his psychosis had resolved, and nephrotic syndrome was found to improve. Children on steroids should be closely monitored for psychotic symptoms over a prolonged duration. Although tapering the dose of steroids is the gold standard treatment of steroid\u2010induced psychosis, cases like nephrotic syndrome demand the continuous use of an immunosuppressant. In such cases, tacrolimus has been found to be an effective alternative, although continuous monitoring for nephrotoxicity is necessary. Similarly, atypical antipsychotics (like quetiapine) are preferred for psychosis because of their lesser risk for extrapyramidal side effects compared to typicals. Parental counseling and informed consent are utmost for children on steroids or tacrolimus.<\/jats:p>","DOI":"10.1002\/ccr3.9642","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T09:44:58Z","timestamp":1732873498000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Steroid\u2010Induced Psychosis in a Child With Nephrotic Syndrome Secondary to Focal Segmental Glomerulosclerosis: A Case Report"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8506-5337","authenticated-orcid":false,"given":"Sushan","family":"Pokharel","sequence":"first","affiliation":[{"name":"Department of Psychiatry B.P. Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrit","family":"Bhusal","sequence":"additional","affiliation":[{"name":"Department of Psychiatry B.P. Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Himal Bikram","family":"Bhattarai","sequence":"additional","affiliation":[{"name":"Department of General Practice and Emergency Medicine Dubai London Hospital  Dubai UAE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tek Nath","family":"Yogi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry B.P. Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabha","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kathmandu University School of Medical Sciences  Dhulikhel Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepti","family":"Pandit","sequence":"additional","affiliation":[{"name":"Department of Psychiatry KIST Medical College  Lalitpur Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101819.2011.02260.x"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165\u20100327(83)90022\u20108"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.9790\/0853\u20101906012627"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0163\u20108343(02)00241\u20104"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/aip.aip_116_21"},{"issue":"3","key":"e_1_2_15_7_1","first-page":"244","article-title":"Steroid\u2010Induced Psychosis in an Adolescent: Treatment and Prophylaxis With Risperidone","volume":"48","author":"Herg\u00fcner S.","year":"2006","journal-title":"Turkish Journal of Pediatrics"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0091217415612735"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2010.53.3.437"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.56305\/001c.81104"},{"key":"e_1_2_15_11_1","unstructured":"Nephcure \u201cTacrolimus (Prograf) \u201daccessed April 16 2024 https:\/\/nephcure.org\/livingwithkidneydisease\/treatment\u2010options\/tacrolimus\u2010prograf\/."},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.1323"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.562"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(71)92738\u20103"},{"key":"e_1_2_15_15_1","unstructured":"American Psychiatric Association \u201cSchizophrenia Spectrum and Other Psychotic Disorders: Substance\/Medication\u2010Induced Psychotic Disorder \u201dDSM\u20105\u2010TR. 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