Upper and lower gastrointestinal complications with dexamethasone despite H2 antagonists.
OBJECTIVE
To describe three preterm babies who developed gastrointestinal complications during treatment with dexamethasone for chronic lung disease, during a 10 month period.


METHODS
Case reports in a tertiary neonatal intensive care unit.


RESULTS
All three babies had received intravenous cimetidine since the commencement of steroid therapy, and developed gastrointestinal complications. There was no evidence of necrotizing enterocolitis in either of the two babies with gastrointestinal perforation. This is the first report of lower gastrointestinal complications associated with dexamethasone therapy.


CONCLUSIONS
Recommendation of concomitant use of H2 antagonists with steroid therapy may be premature, and requires testing with a randomized controlled trial.
McDonnell
M
M
Department of Perinatal Medicine, King George V Hospital for Mothers and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Evans
N
N
D002927:Cimetidine / Q000627:therapeutic use*; D003907:Dexamethasone / Q000009:adverse effects*; D004200:Diseases in Twins; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D006819:Hyaline Membrane Disease / Q000188:drug therapy; D007082:Ileum; D007231:Infant, Newborn; D007234:Infant, Premature; D007416:Intestinal Perforation / Q000139:chemically induced*; D007583:Jejunum; D008297:Male; D009517:New South Wales; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*
D003907:Dexamethasone; D002927:Cimetidine