Steroid Use in Enterovirus and Related Conditions

Q: Steroid Use in Enterovirus and Related Conditions

1. <br>Can enterovirus be treated with steroids? Why? Answer： Steroid treatment is specifically for patients with coxsackievirus myocarditis. <br>However, administering steroids to infants and young children can lead to severe side effects, potentially resulting in death.<br>2. <

Enterovirus and corticosteroids

1.
Can enteroviruses be treated with steroids? Why?
2.
Can patients with diabetes use steroids for treatment? Why?
3.
What is favism? Can it be cured? How is it treated?
4.
Why should patients with gastric ulcers avoid eating congee?

Li Zi Xian, 40~49 year old female. Ask Date: 2003/06/11

Dr. Zheng Shuwen reply Pharmacology

1.
Can enterovirus be treated with steroids? Why? Answer: Steroid treatment is specifically for patients with coxsackievirus myocarditis.
However, administering steroids to infants and young children can lead to severe side effects, potentially resulting in death.
2.
Can patients with diabetes use steroids for treatment? Why? Answer: Diabetes should be treated with antihyperglycemic medications, not steroids.
In fact, patients with severe diabetes are prohibited from using steroids because steroids can increase gluconeogenesis and elevate plasma glucose levels, leading to increased blood sugar concentrations and potentially inducing diabetes.
Caution is necessary.
If diabetic patients have other conditions (such as adrenal insufficiency, arthritis, connective tissue diseases, congenital adrenal hyperplasia, etc.) that require daily steroid use, the dosage of insulin or oral hypoglycemic agents should be increased accordingly.
If steroids are administered every other day, the dosage of diabetes medication should only be increased on the days steroids are taken; however, any dosage adjustments should be discussed with a physician first.
3.
What is favism? Can it be cured? How is it treated? Answer: G-6-PD deficiency, commonly known as favism, is a condition characterized by a deficiency of glucose-6-phosphate dehydrogenase (G-6-PD), an enzyme that helps metabolize glucose in the body and produces a substance that protects red blood cells from certain oxidative agents.
Individuals with this condition lack this enzyme, making their red blood cells susceptible to destruction by specific substances, leading to hemolysis, which can result in acute hemolytic anemia in severe cases.
This inherited metabolic disorder is caused by chromosomal gene abnormalities leading to a deficiency of G-6-PD in red blood cells.
Mild neonatal jaundice can be treated with phototherapy, and mild acute hemolysis is usually self-limiting and requires only supportive care.
However, severe neonatal jaundice or hemolysis may sometimes necessitate blood transfusions or exchange transfusions.
When severe hemolysis causes hemoglobinuria, careful attention to hydration is required to prevent kidney damage.
With appropriate treatment, both neonatal jaundice and acute hemolysis typically resolve quickly without leaving lasting effects.
However, since favism is caused by a genetic defect, there is currently no cure.
To prevent hemolytic episodes, individuals should adhere to the following precautions: 1.
Avoid taking medications without a doctor's prescription.
2.
Avoid eating fava beans or fava bean products.
3.
Do not store mothballs in closets or bathrooms.
4.
Do not use gentian violet.
5.
If jaundice, pallor, or dark red or tea-colored urine is observed, seek medical attention promptly.
6.
When seeking medical care, inform healthcare providers that the child has this condition and present a G-6-PD deficiency alert card.
4.
Why should patients with gastric ulcers avoid eating congee? Answer: Consuming a large amount of watery congee can cause stomach distension and a feeling of bloating, which may lead to stomach pain.

Reply Date: 2003/06/11

More Info

When it comes to the use of steroids in the treatment of enterovirus infections and related conditions, there are several important considerations to keep in mind. Let's break down your questions one by one.

1. Can steroids be used to treat enterovirus infections? Why or why not?
Enteroviruses are a group of viruses that can cause a variety of illnesses, ranging from mild respiratory infections to more severe conditions like viral meningitis or myocarditis. The use of steroids in treating viral infections, including enteroviruses, is generally not recommended. This is because steroids can suppress the immune response, which is crucial for fighting off viral infections. While steroids may reduce inflammation and alleviate symptoms in certain conditions, they do not target the virus itself. In fact, using steroids could potentially worsen the infection by allowing the virus to replicate more freely in the body. Therefore, the consensus in the medical community is to avoid steroids for enterovirus infections unless there are specific complications that warrant their use, such as severe inflammation or an autoimmune response.

2. Can patients with diabetes use steroids for treatment? Why?
Patients with diabetes can use steroids, but with caution. Steroids can increase blood glucose levels, which can complicate diabetes management. This is particularly important for individuals with poorly controlled diabetes, as elevated blood sugar can lead to serious complications. If steroids are necessary for treatment, healthcare providers typically monitor blood glucose levels closely and may need to adjust diabetes medications accordingly. The benefits of using steroids must be weighed against the potential risks, and the decision should be made collaboratively between the patient and their healthcare provider.

3. What is favism? Can it be cured? How is it treated?
Favism is a condition that occurs in individuals with a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD). This deficiency can lead to hemolytic anemia when individuals consume fava beans or are exposed to certain infections, medications, or chemicals. Favism is not curable in the traditional sense, as it is a genetic condition. However, it can be managed effectively. The primary treatment involves avoiding triggers, such as fava beans and certain medications known to cause hemolysis in G6PD-deficient individuals. In cases of hemolytic anemia, supportive care may include hydration, blood transfusions, and monitoring for complications. Education about the condition and its triggers is crucial for individuals with G6PD deficiency.

4. Why should patients with gastric ulcers avoid eating congee (rice porridge)?
Patients with gastric ulcers are often advised to avoid certain foods that can irritate the stomach lining or increase gastric acid production. While congee is generally considered a bland food, it can sometimes be problematic for individuals with ulcers, depending on how it is prepared. If congee is made with added spices, fats, or acidic ingredients, it could exacerbate ulcer symptoms. Additionally, some patients may find that even bland foods can lead to discomfort if consumed in large quantities. The key for ulcer patients is to focus on a diet that is gentle on the stomach, avoiding irritants and opting for easily digestible foods. It is always best for patients to consult with their healthcare provider or a registered dietitian for personalized dietary recommendations.

In summary, the use of steroids in treating enterovirus infections is generally discouraged due to the risk of immune suppression. Diabetes patients can use steroids, but with careful monitoring of blood glucose levels. Favism is a genetic condition that requires avoidance of specific triggers, and gastric ulcer patients should be cautious with their diet to prevent irritation. Always consult with healthcare professionals for tailored advice and treatment plans.

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