{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:18:25Z","timestamp":1777630705907,"version":"3.51.4"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,28]]},"DOI":"10.7759\/cureus.107919","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:05:23Z","timestamp":1777431923000},"source":"Crossref","is-referenced-by-count":0,"title":["Methylprednisolone-Induced Delayed and Sustained Bradycardia in Multisystem Inflammatory Syndrome in Children"],"prefix":"10.7759","author":[{"given":"Sujin M","family":"Thomas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jijo J","family":"John","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keerthy","family":"Kurian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"David","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aby Dany","family":"Varghese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Midhuna","family":"TV","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jomon V","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001483","article-title":"Steroid-induced bradycardia during induction chemotherapy in children and young adults diagnosed with acute lymphoblastic leukemia and lymphoblastic lymphoma","volume":"41","author":"Duffy C","year":"2019","unstructured":"Duffy C, Hall L, Godown J, Koyama T, Borinstein SC. Steroid-induced bradycardia during induction chemotherapy in children and young adults diagnosed with acute lymphoblastic leukemia and lymphoblastic lymphoma. J Pediatr Hematol Oncol. 2019, 41:537-41. 10.1097\/MPH.0000000000001483","journal-title":"J Pediatr Hematol Oncol"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.02.074","article-title":"Bradycardia associated with prednisolone in children with severe Kawasaki disease","volume":"185","author":"Nagakura A","year":"2017","unstructured":"Nagakura A, Morikawa Y, Sakakibara H, Miura M. Bradycardia associated with prednisolone in children with severe Kawasaki disease. J Pediatr. 2017, 185:106-111.e1. 10.1016\/j.jpeds.2017.02.074","journal-title":"J Pediatr"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3390\/children7070069","article-title":"Multi-system inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: review of clinical presentation, hypothetical pathogenesis, and proposed management","volume":"7","author":"Nakra NA","year":"2020","unstructured":"Nakra NA, Blumberg DA, Herrera-Guerra A, Lakshminrusimha S. Multi-system inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: review of clinical presentation, hypothetical pathogenesis, and proposed management. Children (Basel). 2020, 7:10.3390\/children7070069","journal-title":"Children (Basel)"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31815dcfeb","article-title":"Glucocorticoid-associated bradycardia","volume":"30","author":"van der Gugten A","year":"2008","unstructured":"van der Gugten A, Bierings M, Frenkel J. Glucocorticoid-associated bradycardia. J Pediatr Hematol Oncol. 2008, 30:172-5. 10.1097\/MPH.0b013e31815dcfeb","journal-title":"J Pediatr Hematol Oncol"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20020444","article-title":"Clinical use and molecular action of corticosteroids in the pediatric age","volume":"20","author":"Ferrara G","year":"2019","unstructured":"Ferrara G, Petrillo MG, Giani T, et al.. Clinical use and molecular action of corticosteroids in the pediatric age. Int J Mol Sci. 2019, 20:10.3390\/ijms20020444","journal-title":"Int J Mol Sci"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s40124-021-00259-4","article-title":"Treatment of MIS-C in children and adolescents","volume":"10","author":"Mahmoud S","year":"2022","unstructured":"Mahmoud S, El-Kalliny M, Kotby A, El-Ganzoury M, Fouda E, Ibrahim H. Treatment of MIS-C in children and adolescents. Curr Pediatr Rep. 2022, 10:1-10. 10.1007\/s40124-021-00259-4","journal-title":"Curr Pediatr Rep"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-242058","article-title":"Sinus bradycardia in a toddler with multisystem inflammatory syndrome in children (MIS-C) related to COVID-19","volume":"14","author":"Hallberg TC","year":"2021","unstructured":"Hallberg TC, Bjorklund AR, Slusher TM, Rodgers N. Sinus bradycardia in a toddler with multisystem inflammatory syndrome in children (MIS-C) related to COVID-19. BMJ Case Rep. 2021, 14:10.1136\/bcr-2021-242058","journal-title":"BMJ Case Rep"},{"key":"ref8","article-title":"Transient sinus bradycardia in children with multisystem inflammatory syndrome associated with COVID-19","volume":"15","author":"Yal\u00e7\u0131nkaya R","year":"2021","unstructured":"Yal\u00e7\u0131nkaya R, Polat M, Cinni RG, et al.. Transient sinus bradycardia in children with multisystem inflammatory syndrome associated with COVID-19. J Pediatr Inf. 2021, 15:e229-34.","journal-title":"J Pediatr Inf"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/ped.70114","article-title":"Transient sinus bradycardia during the course of MIS-C","volume":"67","author":"Gen\u00e7eli M","year":"2025","unstructured":"Gen\u00e7eli M, Akcan \u00d6M, K\u0131l\u0131n\u00e7 SB, Sayl\u0131k S, Kocao\u011flu M, Sara\u00e7 U, Oflaz MB. Transient sinus bradycardia during the course of MIS-C. Pediatr Int. 2025, 67:e70114. 10.1111\/ped.70114","journal-title":"Pediatr Int"},{"key":"ref10","unstructured":"Indian Pharmacopoeia Commission. Guidance document for spontaneous adverse drug reaction reporting. (2014). Accessed: April 26, 2026: https:\/\/ipc.gov.in\/images\/pdf\/File268.pdf."},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/art.41454","article-title":"American College of Rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: version 1","volume":"72","author":"Henderson LA","year":"2020","unstructured":"Henderson LA, Canna SW, Friedman KG, et al.. American College of Rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: version 1. Arthritis Rheumatol. 2020, 72:1791-805. 10.1002\/art.41454","journal-title":"Arthritis Rheumatol"},{"key":"ref12","unstructured":"World Health Organization. Multisystem inflammatory syndrome in children and adolescents with COVID-19. (2020). Accessed: April 26, 2026: https:\/\/www.who.int\/publications\/i\/item\/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19."},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/9781118369784","article-title":"Advanced Paediatric Life Support: The Practical Approach","author":"Advanced Life Support Group","year":"2011","unstructured":"Advanced Life Support Group. Advanced Paediatric Life Support: The Practical Approach. Samuels M, Wieteska S (ed): Wiley\u2011Blackwell, 2011. 10.1002\/9781118369784"},{"key":"ref14","unstructured":"SAS\u00ae software. (2025). Accessed. April 26, 2026:  https:\/\/www.sas.com\/en_us\/software\/stat.html."},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.626182","article-title":"Multisystem inflammatory syndrome in children (MIS-C), a post-viral myocarditis and systemic vasculitis-a critical review of its pathogenesis and treatment","volume":"8","author":"McMurray JC","year":"2020","unstructured":"McMurray JC, May JW, Cunningham MW, Jones OY. Multisystem inflammatory syndrome in children (MIS-C), a post-viral myocarditis and systemic vasculitis-a critical review of its pathogenesis and treatment. Front Pediatr. 2020, 8:626182. 10.3389\/fped.2020.626182","journal-title":"Front Pediatr"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-026-06798-6","article-title":"Post-MIS-C cardiovascular outcomes: a systematic review","volume":"185","author":"Alvarado-Gamarra G","year":"2026","unstructured":"Alvarado-Gamarra G, Alcala-Marcos K, Celis CR, et al.. Post-MIS-C cardiovascular outcomes: a systematic review. Eur J Pediatr. 2026, 185:10.1007\/s00431-026-06798-6","journal-title":"Eur J Pediatr"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.667507","article-title":"Best practice recommendations for the diagnosis and management of children with pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS; multisystem inflammatory syndrome in children, MIS-C) in Switzerland","volume":"9","author":"Schlapbach LJ","year":"2021","unstructured":"Schlapbach LJ, Andre MC, Grazioli S, et al.. Best practice recommendations for the diagnosis and management of children with pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS; multisystem inflammatory syndrome in children, MIS-C) in Switzerland. Front Pediatr. 2021, 9:667507. 10.3389\/fped.2021.667507","journal-title":"Front Pediatr"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0029","article-title":"Sinus bradycardia after intravenous pulse methylprednisolone","volume":"119","author":"Akikusa JD","year":"2007","unstructured":"Akikusa JD, Feldman BM, Gross GJ, Silverman ED, Schneider R. Sinus bradycardia after intravenous pulse methylprednisolone. Pediatrics. 2007, 119:e778-82. 10.1542\/peds.2006-0029","journal-title":"Pediatrics"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1159\/000168087","article-title":"Holter electrocardiogram monitoring in nephrotic patients during methylprednisolone pulse therapy","volume":"10","author":"Fujimoto S","year":"1990","unstructured":"Fujimoto S, Kondoh H, Yamamoto Y, Hisanaga S, Tanaka K. Holter electrocardiogram monitoring in nephrotic patients during methylprednisolone pulse therapy. Am J Nephrol. 1990, 10:231-6. 10.1159\/000168087","journal-title":"Am J Nephrol"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_2167_22","article-title":"Bradycardia after pulse methylprednisolone therapy in a child-uncommon side effect of a frequently used drug: a case report","volume":"12","author":"Tripathy SK","year":"2023","unstructured":"Tripathy SK, Das S, Malik A. Bradycardia after pulse methylprednisolone therapy in a child-uncommon side effect of a frequently used drug: a case report. J Family Med Prim Care. 2023, 12:1006-8. 10.4103\/jfmpc.jfmpc_2167_22","journal-title":"J Family Med Prim Care"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27525","article-title":"A rare case of drug-induced bradycardia associated with the just low dose use of methylprednisolone in a child with COVID-19","volume":"94","author":"Jiang P","year":"2022","unstructured":"Jiang P, Wu SH, Zhu T, Guo Y, He Y. A rare case of drug-induced bradycardia associated with the just low dose use of methylprednisolone in a child with COVID-19. J Med Virol. 2022, 94:1745-7. 10.1002\/jmv.27525","journal-title":"J Med Virol"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951120004308","article-title":"Low-dose steroid-induced bradyarrhythmias and treatment refractory hypokalaemia: a case report","volume":"31","author":"Ghosh A","year":"2021","unstructured":"Ghosh A, Annigeri S, Nair A. Low-dose steroid-induced bradyarrhythmias and treatment refractory hypokalaemia: a case report. Cardiol Young. 2021, 31:651-3. 10.1017\/S1047951120004308","journal-title":"Cardiol Young"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytab405","article-title":"Bradycardia associated with multisystem inflammatory syndrome in children with COVID-19: a case series","volume":"5","author":"Ciccarelli GP","year":"2021","unstructured":"Ciccarelli GP, Bruzzese E, Asile G, et al.. Bradycardia associated with multisystem inflammatory syndrome in children with COVID-19: a case series. Eur Heart J Case Rep. 2021, 5:ytab405. 10.1093\/ehjcr\/ytab405","journal-title":"Eur Heart J Case Rep"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1177\/1715163515597451","article-title":"Corticosteroid-induced bradycardia: case report and review of the literature","volume":"148","author":"Stroeder J","year":"2015","unstructured":"Stroeder J, Evans C, Mansell H. Corticosteroid-induced bradycardia: case report and review of the literature. Can Pharm J (Ott). 2015, 148:235-40. 10.1177\/1715163515597451","journal-title":"Can Pharm J (Ott)"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-018-4167-1","article-title":"Dose-dependent bradycardia as a rare side effect of corticosteroids: a case report and review of the literature","volume":"38","author":"\u00dcsk\u00fcdar Cansu D","year":"2018","unstructured":"\u00dcsk\u00fcdar Cansu D, Bodak\u00e7i E, Korkmaz C. Dose-dependent bradycardia as a rare side effect of corticosteroids: a case report and review of the literature. Rheumatol Int. 2018, 38:2337-43. 10.1007\/s00296-018-4167-1","journal-title":"Rheumatol Int"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-173-41653","article-title":"Acute cardiovascular response to a single large intravenous dose of methylprednisolone and its effects on the responses to norepinephrine and isoproterenol","volume":"173","author":"Hall ED","year":"1983","unstructured":"Hall ED, Plaster M, Braughler JM. Acute cardiovascular response to a single large intravenous dose of methylprednisolone and its effects on the responses to norepinephrine and isoproterenol. Proc Soc Exp Biol Med. 1983, 173:338-43. 10.3181\/00379727-173-41653","journal-title":"Proc Soc Exp Biol Med"},{"key":"ref27","article-title":"Adverse effects of corticosteroids on the cardiovascular system","volume":"16","author":"Sholter DE","year":"2000","unstructured":"Sholter DE, Armstrong PW. Adverse effects of corticosteroids on the cardiovascular system. Can J Cardiol. 2000, 16:505-11.","journal-title":"Can J Cardiol"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/476691-methylprednisolone-induced-delayed-and-sustained-bradycardia-in-multisystem-inflammatory-syndrome-in-children","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:05:30Z","timestamp":1777431930000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/476691-methylprednisolone-induced-delayed-and-sustained-bradycardia-in-multisystem-inflammatory-syndrome-in-children"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":27,"URL":"https:\/\/doi.org\/10.7759\/cureus.107919","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,28]]}}}