High-dose methylprednisolone in a pregnant woman with Crohn's disease and adrenal suppression in her newborn.
BACKGROUND
The synthetic corticosteroid methylprednisolone is used for the treatment of acute exacerbations of Crohn's disease, also in pregnancy. Its use is considered to be less harmful than the effect of active disease on the fetus. Adrenal suppression in a fetus due to administration of methylprednisolone has hitherto been rarely published.


OBJECTIVE
To present a case of neonatal adrenal suppression due to the use of high-dose methylprednisolone in late pregnancy of a woman with Crohn's disease.


RESULTS
Clinical signs of adrenal suppression were observed in the newborn 3 h after birth. After hydrocortisone supplementation and intensive therapy the baby recovered completely.


CONCLUSIONS
Life-threatening adrenal suppression, requiring hydrocortisone supplementation and intensive therapy, was observed and successfully treated in a newborn, whose mother had received high-dose methylprednisolone in late pregnancy.
Homar
Vesna
V
Department of Pediatric Surgery and Intensive Therapy, University Medical Center Ljubljana, Ljubljana, Slovenia.
Grosek
Stefan
S
Battelino
Tadej
T
D000309:Adrenal Insufficiency / Q000139:chemically induced* / Q000188:drug therapy; D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D007231:Infant, Newborn; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*
D006854:Hydrocortisone; D008775:Methylprednisolone