{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:33:20Z","timestamp":1787762000738,"version":"build-2784847793"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>Corticosteroids are potent anti-inflammatory agents used as a mainstay of therapy in most of the rheumatologic disorders. Common side effects of pulse steroid therapy include hypertension, hyperglycemia, seizure, hypokalemia, and infection. We report a case of an 11-year-old girl with polyarticular Juvenile idiopathic arthritis who developed bradycardia following pulse methylprednisolone therapy. On day 2 of methylprednisolone infusion, she developed bradycardia with a heart rate between 50 and 60\/min. ECG was suggestive of sinus bradycardia. There was no evidence of dyselectrolytemia (Na\u2014141 mmol\/l, K\u20143.54 mmol\/l, Ca\u20148.72 mg\/l) or sepsis. The patient did not receive methylprednisolone on day 3 and vitals continued to be monitored. Her heart rate improved after 12 hours. In the mid of infusion on day 4, again the patient had bradycardia with a heart rate of 50\u201360\/minute. Since she was hemodynamically stable, we continued the infusion, and bradycardia resolved in the next 8 hours. On follow-up after 2 weeks, she had some improvement in joint symptoms and normal heart rate. As per Naranjo adverse drug reaction probability scale, the adverse reaction in our case was probable with a score of 8. Although bradycardia associated with pulse steroid therapy is benign and is usually reversible following cessation of therapy, a baseline heart rate, ECG, and electrolyte level are suggested before infusion as a cautionary measure to minimize serious adverse events.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_2167_22","type":"journal-article","created":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T03:01:27Z","timestamp":1685329287000},"page":"1006-1008","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Bradycardia after pulse methylprednisolone therapy in a child\u2014Uncommon side effect of a frequently used drug: A case report"],"prefix":"10.4103","volume":"12","author":[{"given":"Saroj K.","family":"Tripathy","sequence":"first","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarthak","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"R1-20240828","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1007\/s12098-008-0210-7","article-title":"Pulse steroid therapy","volume":"75","author":"Sinha","year":"2008","journal-title":"Indian J Pediatr"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1177\/1715163515597451","article-title":"Corticosteroid-induced bradycardia:Case report and review of the literature","volume":"148","author":"Stroeder","year":"2015","journal-title":"Can Pharm J (Ott)"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","author":"Naranjo","year":"1981","journal-title":"Clin Pharacol Ther"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1177\/1715163515597451","article-title":"Corticosteroid-induced bradycardia:Case report and review of the literature","volume":"148","author":"Stroeder","year":"2015","journal-title":"Can Pharm J (Ott)"},{"key":"R5-20240828","first-page":"47","article-title":"Bradycardia following oral corticosteroid use:Case report and literature review","volume":"5","author":"Al Shibli","year":"2012","journal-title":"Arab J Nephrol Transplant"},{"key":"R6-20240828","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1007\/s00380-013-0443-x","article-title":"Three cases of corticosteroid therapy triggering ventricular fibrillation in J-wave syndromes","volume":"29","author":"Sakamoto","year":"2014","journal-title":"Heart Vessels"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"e778","DOI":"10.1542\/peds.2006-0029","article-title":"Sinus bradycardia after intravenous pulse methylprednisolone","volume":"119","author":"Akikusa","year":"2007","journal-title":"Pediatrics"},{"key":"R8-20240828","first-page":"e15065","article-title":"Steroid-induced sinus bradycardia","volume":"13","author":"Khandelwal","year":"2021","journal-title":"Cureus"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_2167_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:10:04Z","timestamp":1787760604000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_2167_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":8,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_2167_22","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2022-11-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}