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[Complications during systemic corticosteroid therapy combined with orbital radiotherapy in patients with graves orbitopathy].

OBJECTIVE
An assessment of complications during systemic corticosteroid therapy combined with orbital radiotherapy in patients with thyroid eye disease.


MATERIAL
101 patients including 86 women and 15 men hospitalized in the Endocrinology Department of Pomeranian Medical Academy in 1999-2002.


METHODS
During the first stage of therapy, methylprednisolone in a daily dose of 1.0 g was administered intravenously for the following 3 days. The number of methylprednisolone pulses ranged from 3 up to 6-7. Orbital radiotherapy was usually performed between 2 and 4 pulse. Ten daily doses of 200 cGy were given in 2 weeks. After the series of methylprednisone and orbital radiotherapy had been finished, patients were treated with prednisone (Encorton, Polfa) given orally with an initial dose of 60 mg/day.


RESULTS
During the first stage of therapy carbohydrate metabolism disturbances were observed in 27 patients. Cardio-vascular complications were noted in 8 patients. Four patients complained of digestive tract dysfunction. Acute psychosis was diagnosed in 3 patients. Twelve patients developed infectious diseases. During prednisone administration, 1 case of bacterial pneumonia, 1 purulent meningitis and 1 schizophrenia onset were observed. In prolonged ophthalmologic follow-up 3/101 patients with cataract needed surgical treatment.