Side effects of cortisone
Pro Research Analysisby 
Searched over 200M research papers
Side Effects of Cortisone
Cortisone, a corticosteroid, is widely used for its anti-inflammatory and immunosuppressive properties. However, its use is associated with a range of side effects, which can vary depending on the dosage, duration of treatment, and the specific condition being treated. This article synthesizes the key findings from recent research on the side effects of cortisone.
Neuropsychiatric Side Effects in Pediatric Patients
Corticosteroids, including cortisone, can have significant neuropsychiatric side effects in children. These effects can manifest as cognitive disorders, behavioral changes, and even psychiatric diseases. Studies have shown that acute exposure to corticosteroids in pediatric patients, particularly those with acute lymphoblastic leukemia, is associated with negative psychiatric and behavioral effects. Additionally, children treated with corticosteroids for non-cancer conditions have exhibited adverse effects both during and after treatment, although the data is inconsistent regarding dose relationships1 5 8.
Musculoskeletal Side Effects
Cortisone use is linked to several musculoskeletal side effects. Prolonged use can lead to osteoporosis and vertebral fractures. There are also reports of joint destruction and severe hip-joint arthropathy, particularly with high-dosage corticosteroid therapy. These effects are often described as "Charcot-like" in character and genesis, indicating severe joint damage3 7. Additionally, cortisone can cause toxicity to articular cartilage, which may result in joint pain and deterioration, necessitating major surgeries like arthroplasties2 7.
Systemic Side Effects
Cortisone can cause a range of systemic side effects. One of the most significant is its impact on the immune system, leading to a reduction in immune function and an increased risk of infections. This immunosuppressive effect can make patients more susceptible to bacterial infections and can even reactivate dormant infections such as tuberculosis. High doses of cortisone are particularly associated with these risks6 9. Other systemic side effects include increases in blood glucose levels, which can be particularly concerning for diabetic patients2.
Specific Pediatric Concerns
In pediatric practice, the use of cortisone and adrenocorticotropin (ACTH) has been associated with serious side reactions. These include potential hazards that may not yet be clinically expressed but pose significant risks. The implications of these observations suggest that while cortisone can be effective, its use in children must be carefully monitored to avoid severe adverse effects5 8.
Conclusion
While cortisone is an effective treatment for various inflammatory and autoimmune conditions, its use is accompanied by a range of potential side effects. These include neuropsychiatric effects, particularly in pediatric patients, musculoskeletal damage, and systemic issues such as immune suppression and increased infection risk. Physicians must weigh these risks against the benefits when prescribing cortisone and monitor patients closely to mitigate adverse effects. Further research is needed to develop strategies that minimize these side effects while maintaining the therapeutic benefits of cortisone.
Sources and full results
Most relevant research papers on this topic
Psychiatric adverse effects of pediatric corticosteroid use.
Pediatric corticosteroid use may have mixed neuropsychiatric effects, with some reports of deficits in functioning, while inhaled corticosteroids are generally considered safe and free of severe neuropsychiatric effects.
Systematic Review
Highly CitedCorticosteroids: Review of the History, the Effectiveness, and Adverse Effects in the Treatment of Joint Pain.
Corticosteroids provide moderate short-term pain relief and improved function for joint pain, but have potential adverse effects like toxic damage to cartilage and systemic side effects.
Systematic ReviewAvascular necrosis of the femoral and humeral heads after high-dosage corticosteroid therapy.
High-dose corticosteroid therapy can cause severe joint damage, including avascular necrosis of the femoral and humeral heads, in some patients.
Case ReportHighly CitedBiotransformation of Cortisone with Rhodococcus rhodnii: Synthesis of New Steroids
Biotransformation of cortisone with Rhodococcus rhodnii produces two new steroids with similar anti-inflammatory properties but less side effects, offering a sustainable green chemistry approach.
Serious untoward reactions to therapy with cortisone and adrenocorticotropin in pediatric practice. II.
Serious untoward side reactions have been observed in children treated with ACTH and cortisone, highlighting potential hazards in their use in pediatrics.
Highly CitedReversal by Diethyl-Stilbœstrol of the Depressant Effect of Cortisone on the Phagocytic Activity of the Reticulo-endothelial System
Diethyl-stilbestrol reverses the depressant effect of cortisone on the phagocytic activity of the reticulo-endothelial system, suggesting that doses above 100 mg/day may cause adverse side-effects.
Overuse and abuse of cortisone.
Overuse and abuse of cortisone can lead to serious side effects, including joint infection, tendon weakening, osteoporosis, and osteoarthritis, which may require major surgeries like arthroplasties.
Serious untoward reactions to therapy with cortisone and adrenocorticotropin in pediatric practice. I.
Cortisone and adrenocorticotropin therapy in pediatric practice can cause serious untoward reactions, including gastrointestinal disturbances, pulmonary hypertension, and thrombocytopenia.
Improving systemic corticosteroid stewardship in asthma
Previous duration and cumulative dose of oral corticosteroids influence the likelihood to achieve corticosteroid tapering after initiating IL-5/IL5R biologics for severe asthma.
Rigorous Journal