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Hashimoto's encephalopathy, also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a neurological condition characterized by encephalopathy, thyroid autoimmunity, and good clinical response to corticosteroids. It is associated with Hashimoto's thyroiditis, and was first described in 1966.
Historically, higher doses of steroids were given, but these have been suggested to be harmful compared to the lower doses which are advocated today. [ 23 ] In the CORTICUS study, hydrocortisone hastened the reversal of septic shock, but did not influence mortality, with an increased occurrence of septic shock relapse and hypernatremia . [ 20 ]
Methylprednisolone is commonly prescribed as short-term therapy for acute flares, as seen with acute gouty arthritis. It can be prescribed during on-going therapy in lower doses contingent upon monitorization of adverse effects. [5] Dosage strength and formulation are optimized per medical use. [6]
Estrone has been used by intramuscular injection at a dosage of 0.1 to 2 mg per week, or 0.1 to 0.5 mg given 2 or 3 times per week, for the treatment of menopausal symptoms such as hot flashes and vaginal atrophy, [20] [21] and at a dosage of 0.1 to 1.0 mg weekly in single or divided doses for the treatment of female hypogonadism, surgical ...
This weaning process may be over a few days if the course of prednisone is short but may take weeks or months [33] if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis. For those on chronic therapy, alternate-day dosing may preserve adrenal function and thereby reduce side effects. [34]
Emergent intramuscular dosing can be given if child is not tolerating oral medications or unable to get IV within 15 minutes. IM hydrocortisone sodium succinate doses are: [3] 25 mg for child 3 years and younger; 50 mg for children >3 yrs – 12 years; 100 mg for children 12 years and older.
If high doses were used for six to 10 days, reduce to replacement dose immediately and taper over four more days. Adrenal recovery can be assumed to occur within two to four weeks of completion of steroids. If high doses were used for 11–30 days, cut immediately to twice replacement, and then by 25% every four days.
Megestrol acetate has been found to dose-dependently increase total and free IGF-1 levels up to a dosage of 120 mg/day. [131] Total IGF-1 levels were described as "profoundly" increased, gradually increasing, significantly by 3 days of treatment, up to a maximum of 2.66-fold by 5 to 6 months of treatment. [ 131 ]