Bad reaction to prednisone

[AnitaS]

I was wondering if anyone else has had a bad reaction to prednisone. My son completely flipped out on day 3. The best way I could describe his behaviour was mania. He was crying, saying the same phrase over and over and over, became aggressive....... Our ped told us to stop immediately. He was fine the next day. Does this mean my son is not a good candidate for IVIG? We had a similar reaction to Sporonox when we were treating yeast overgrowth. I don't know if this is related or not.

[beeskneesmommy]

Hi:

 

We see a specialist at Children's Hosp. of Phila. When we first went, I asked about steroids because I had heard that they worked well. She was very conservative about it and told me that in small children, steroids can cause psychotic symptoms (my son is 4). She said that she would likely hospitalize him if we did a trial because of this. We chose not to follow thru with that course and keep it for an ace in the hole, so to speak.

 

I am so sorry that your kiddo had an adverse response, although it is my understanding that a course of steroids can have very good results...

 

Best wishes!

[kimballot]

Hi Anita -

 

First off - welcome to the forum. It is good to read your questions and know that you are working with a pediatrician who is trying hard to help you and your son.

 

I am trying to piece together your posts - I think you are saying that you have a 7 year old son who was diagnosed with autism at 2 and PANDAS at 6. He recently had scarlitina - did well with the abx prescribed, but now has scarlitina again AND he was put on prednisone but had a bad reaction. Is that correct?

 

It sounds like your pediatrician is really trying to help - but I would really recommend you try to find a DAN! doctor who is familiar with PANDAS or a PANDAS doc to consult with.

 

I am concerned that your son never really eradicated the strep the first time around. I am not sure why the prednisone was prescribed, but I know my doctor tries to get rid of the infection first, before prescribing prednisone. Prednisone reduces inflammation and stops autoimmune responses, but it also slows down the immune system, so the immune system cannot fight infection well. That is why kids with lyme disease often do poorly with prednisone - because it allows the lyme to go unchecked for a while.

 

Perhaps you should be treating with the antibiotics - and then consider prednisone if you are still having PANDAS symptoms once the infection clears. I hope that makes sense - if not - let me know.

 

Also - regarding the sporonox - that was probably a herx reaction from the yeast die off... yes.. they could be somewhat related. If the prenisone stopped the body from fighting bacteria, then the bacteria and yeast may have been in somewhat of a conflict and the yeast may have died off a bit ... but that is a just a long shot speculation. In any event - be sure to use lots of probiotics with the antibiotic.

 

Best wishes -

[AnitaS]

Hi Anita -

 

First off - welcome to the forum. It is good to read your questions and know that you are working with a pediatrician who is trying hard to help you and your son.

 

I am trying to piece together your posts - I think you are saying that you have a 7 year old son who was diagnosed with autism at 2 and PANDAS at 6. He recently had scarlitina - did well with the abx prescribed, but now has scarlitina again AND he was put on prednisone but had a bad reaction. Is that correct?

 

It sounds like your pediatrician is really trying to help - but I would really recommend you try to find a DAN! doctor who is familiar with PANDAS or a PANDAS doc to consult with.

 

I am concerned that your son never really eradicated the strep the first time around. I am not sure why the prednisone was prescribed, but I know my doctor tries to get rid of the infection first, before prescribing prednisone. Prednisone reduces inflammation and stops autoimmune responses, but it also slows down the immune system, so the immune system cannot fight infection well. That is why kids with lyme disease often do poorly with prednisone - because it allows the lyme to go unchecked for a while.

 

Perhaps you should be treating with the antibiotics - and then consider prednisone if you are still having PANDAS symptoms once the infection clears. I hope that makes sense - if not - let me know.

 

Also - regarding the sporonox - that was probably a herx reaction from the yeast die off... yes.. they could be somewhat related. If the prenisone stopped the body from fighting bacteria, then the bacteria and yeast may have been in somewhat of a conflict and the yeast may have died off a bit ... but that is a just a long shot speculation. In any event - be sure to use lots of probiotics with the antibiotic.

 

Best wishes -

[AnitaS]

Hi Kim,

 

Thanks for your reply. You're right. My son was dx with Autism at 2 PANDAS at 6 (Nov 2010). Thanks for taking the time to piece together my posts. My son's ped is a DAN doctor but doesn't have a lot of experience with PANDAS. Here is a brief summary of our PANDAS journey:

 

At 4 our ped suspected PANDAS at an appt we had when she saw some of my son's 'cycling' behaviours. She took a throat swab. It came back negative and we moved away from looking into PANDAS.

 

We treated Clostridia with Flagyl and saw huge gains.

 

2 years later our ped realized that my son's beh always increased after a sickness. She speculated that we saw such improvement from Flagyl because we may have been indirectly treating PANDAS. We decided to treat my son with antibiotics. 5 days of 200mg of azith followed by 80 mg 3X week. We saw gains, especially with anxiety and OCD behaviours.

 

In Jan 2011 after doing some exploring into PANDAS I read that a steroid burst could help. She agreed to try and we had the reaction I described.

 

PANDAS beh worsened in Feb and we treated with azith 10 days 80mg a day. My son developed scarlitina and we gave him 10 days of penicillin 450mg 2X day (beginning of Mar). We saw huge improvements. A few weeks after he developed a coughing tic. 5 more days of 80mg azith a day. We have been on a maintenance dose of azith since.

 

Recently, we have seen evidence of scarlitina (rash and a resurfacing of beh) and have been prescibed penicillin again. I have looked into seeing Dr K but we are in Canada....... have also thought of possibly seeing Dr. Bock.

 

Some of the behaviours my son exhibits are:

urinary frequency (sometimes going every 10 min)

OCD beh (repeating the same thing over or doing some routine a certain way over and over)

coughing tic (short cough every 5 seconds)

one summer he refused to leave the house for 3 weeks

obsessed with where I am, where I am going.......

dilated pupils when he is 'cycling'

 

Any other suggestions/advice would be greatly appreciated. Sorry for the lengthy response.

 

Anita

[sf_mom]

Anita it is very possible that your son has Lyme induced Autism. http://www.lymeinducedautism.com/

 

A couple of things stick out in my mind.

 

1. Adverse reaction to prednisone. Kimballots post is correct.... steroids can give chronic infection the leg up causing adverse effect.

 

2. Your son responded so well to flagyl. Flagyl it a very powerful antibiotic that commonly used to treat Lyme in its cyst form.

 

3. Urinary frequency - Lyme loves the bladder and is often a symptom

 

4. Coughing - unproductive 'coughing tic' is often a sign of Babesia/Bartonella which are co-infection to Lyme.

 

Please explore possible chronic infection with your Dr. or LLMD 'Lyme LIterate Dr.' recommended through ILADS. They are having great success helping children with Lyme induced Autism.

 

-Wendy

Edited May 22, 2011 by SF Mom

[Stephanie2]

I didn't read the other replies but in our experiences steroids caused steroid-induced psychosis in one of my boys (later to find out it was probably related to the fact that he was taking it concominently with Ketoconozole), and another scenario we have had is that steroids do a number on gut infections, it could be clostridia (the repeating phrases is one clue in my house, so is the aggression). With sporonox, it could be that the liver could not excrete it quickly enough so it built up and caused behavior issues, OR it could be that by killing so much yeast, that allowed bacteria (clostridia or other) in the gut to take over. For my boys, if I treat yeast they would both have clostridia within a few days.

 

with all that being said, I am now treating all of this with homeopathy with very good success, but that was our experience in the past with these meds.

[AnitaS]

Anita it is very possible that your son has Lyme induced Autism. http://www.lymeinducedautism.com/

 

A couple of things stick out in my mind.

 

1. Adverse reaction to prednisone. Kimballots post is correct.... steroids can give chronic infection the leg up causing adverse effect.

 

2. Your son responded so well to flagyl. Flagyl it a very powerful antibiotic that commonly used to treat Lyme in its cyst form.

 

3. Urinary frequency - Lyme loves the bladder and is often a symptom

 

4. Coughing - unproductive 'coughing tic' is often a sign of Babesia/Bartonella which are co-infection to Lyme.

 

Please explore possible chronic infection with your Dr. or LLMD 'Lyme LIterate Dr.' recommended through ILADS. They are having great success helping children with Lyme induced Autism.

 

-Wendy

[AnitaS]

Thank you so much. I have been reseaching Lyme Disease for the last 2 days non stop and am definately going to explore this. My gut tells me this is it.......when I look back over the past few years it all is starting to make sense. My son definately has a chronic infection of some kind. I have pictures of rashes he's had over the years (usually when he is on an antifungal-so I always attributed them to die off) that look very similar to one of the rashes I saw on the autism-induced-lyme website you included in your response. I hate to say that I am excited that my son could possibly have Lyme Disease but now I feel like if we know what we are dealing with we can really help him. I will be talking to my son's ped today. Thank you so much........

[EAMom]

2 years later our ped realized that my son's beh always increased after a sickness. She speculated that we saw such improvement from Flagyl because we may have been indirectly treating PANDAS. We decided to treat my son with antibiotics. 5 days of 200mg of azith followed by 80 mg 3X week. We saw gains, especially with anxiety and OCD behaviours.

 

In Jan 2011 after doing some exploring into PANDAS I read that a steroid burst could help. She agreed to try and we had the reaction I described.

 

PANDAS beh worsened in Feb and we treated with azith 10 days 80mg a day. My son developed scarlitina and we gave him 10 days of penicillin 450mg 2X day (beginning of Mar). We saw huge improvements. A few weeks after he developed a coughing tic. 5 more days of 80mg azith a day. We have been on a maintenance dose of azith since.

 

 

Hi Anita,

 

I would rec. using higher doses of Azith. I don't know how much your son weighs, but my dd started on Azith. 250mg 1x daily at 42 pounds (almost 8 at the time...she had PANDAS induced anorexia). She's been on that dose for the past 3 years (occasionally going up to 500mg/day for a mo. at a time, and we did 1 mo. of Augmentin XR 1000mg 2x daily). She's in 5th grade now (70 something pounds).

 

Also, have you tried advil? does that help?

 

I agree with the others about making sure infections are wiped out before starting pred. With strep that can be tricky (since it can hide out), but I would say I would recommend at least (IMHO) 2 mo. of full-strength azith (so 250mg/day for a 40 something pound child) before starting pred (and continue that dose while doing the pred).

 

That said, my dd did get more irritable on pred (we've done 5-6 days worth a couple of time) but she would have temporary PANDAS symptom improvement about 2 weeks later.

 

Also, be sure to throat culture family members to check for carriers.

 

PS are you familiar with this Canadian PANDAS case? http://www.ctvbc.ctv.ca/servlet/an/local/CTVNews/20110517/bc_pandas_therapy_110517/20110517/?hub=BritishColumbiaHome