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Sudden death on steroids

MagazineJune 1996 (Vol. 7 Issue 3)Sudden death on steroids

Steroids, even in low doses, can kill or maim

Steroids, even in low doses, can kill or maim. The common thread in the following cases was that the drugs weren't used for long periods but had a swift and devastating effect.

Steroids gave James Hart osteoporosis in three months and killed him inside of one year. In July 1994, James Hart was diagnosed as having fibrosing alveolitis, a lung disease. A body dye scan at the time showed that he was otherwise healthy, with every other organ besides the lung in good shape. Up until that spring, he'd been a keen golfer, playing a full round twice a week. He was given oxygen therapy at home, plus 12 tablets of 5 mg of prednisolone per day. The drug was intended to give his body a boost, to help him gain weight. Within a month, however, James's weight increased dramatically, bloating out of all proportion. His skin became very thin and his arms and hands were discoloured purple, bruising at the slightest touch. Although the steroids weren't alleviating the lung problem to any degree, and the dosage was halved within a month, James suffered terrible mood swings, and soon developed a misshapen neck and back, usually termed buffalo hump, a well known side effect of steroids.Five months after he'd started on steroids, James was crippled and incapacitated, with pain to his back and ribs; eventually, his family discovered he had a broken vertebrae and damaged rib cage due to osteoporosis. He was no longer able to go to the toilet on his own, and a month later, he'd contracted diabetes and developed a liver problem.

By early June 1995 he could no longer eat due to mouth and gum ulcers, which were slow to heal. A month later exactly a year after he'd started on steroids James died of liver, pancreatic and kidney failure. When he was dying, his family could not even hold his hands, because it would damage his skin and cause blood vessels to leak. On his death certificate, the lung disease was not considered the major cause of his death.

Steroids killed nine year old Lexie McConnell after only five and a half weeks. In August 1993, Lexie was diagnosed as having toxoplasmosis. The consultant put her on 80 mg per day of prednisolone. Immediately, she suffered severe side effects huge weight gain, terrible pains, holes in her tongue and black stools. After nearly a month, at her parents' pleading, the doctors quickly lowered the dosage to 60 mg, 40 mg, 20 mg. In excruciating pain, Lexie was taken to a hospital, where it was discovered she'd contracted chickenpox. Four days later, she died. A few years later, another eye specialist declared that a simple course of antibiotics could have cleared up her infection (see Viewpoint, p 6).

Mrs Aston was a fit, healthy 60 year old with slightly high blood pressure. After a fall ruptured her spleen, she had a splenectomy, which left her with asthma. Although started on bronchodilators, she was put on steroid inhalers, then tablets, then injections. Her asthma got worse, necessitating continuous steroids. From a size 10, she ballooned up to size 18, and her skin became so papery that on occasions the vessels would leak and blood gush out. Eventually she was given tablets to counteract the steroids, and then developed what appears to be osteoporosis.


Sporanox

Lexie's legacy

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