I think we need more clinical trials. Many senior consultants prescribe them quoting personal experiences. It is established fact that steroids help in autoimmune disorders.
Dear Dr Sreenivasa Rao Sudulagunta,
Which stage of dengue are we talking about?
There is definitely no role of steroids for fever, thrombocytpenia and even dengue hemorrhagic fever.
When it comes down to a person of dengue who has gone into shock, the evidence is controversial. Even here, if at all someone is giving it, then it gets covered under the shock protocol similar to management of septic shock. Such cases are rare and open to discussion.
For all other forms of dengue there is definitely no role of steroids.
regards
Dear Dr Sreenivasa Rao,
Still now, No role of steroids in Dengue fever was studied by researchers; But there may be some support in initial stages of Dengue unlike in fever and in after stages like in pain killing(?)
The treatment of dengue is Paracetamol for fever & fluid therapy . Adequate Oral fluids are given for mild dengue & IV fluids for severe dengue . There is no role for steroids , at present , as there is no evidence for their role . It would be preferable if consultants , who are using them publish their data , as to the specific indication for steroids & share their experience . None of the existing guidelines have mentioned the role of steroids in the management of dengue .
There have been several studies of steriods for dengue. There has been quite a large one by Prof.Cameron Simmons group which show that they do not work. They have also then investigated why it doesn't work which is published.
Hi,
Not a clinician, but the literature cautions against steroids and other, aggressive management: RBC, platelets, whole blood transfusions, in favor of 24/7 monitoring of fluids, O2 saturation, and other supportive care measures. When patients go into hypovolemic shock, better to follow the CDC Algorithm with non-crystalloid, then crsytalloid replacements and repeat blood draws to restore hemodynamic stability.
Hi, several therapeutic options are being weighed for the "cytokine storm" in dengue. Steroid is still not recommended.
Please see the Cochrane review 2014 regarding this topic.
Stay healthy stay blessed
-Aniruddha
Kindly see the following RG links and PDF attachments.
Article Effectiveness of corticosteroid in the treatment of dengue –...
Article Corticosteroids in the treatment of dengue shock syndrome
Deleted research item The research item mentioned here has been deleted
Article Methylprednisolone in dengue patients with alarm signs: The ...
Article Corticosteroids for Dengue - Why Don't They Work?
Hello,
All these answers seems helpful BUt what about the case when patient is taking steroids for a whole years. So should he continue to take it?
Patient was diagnosed with misthania gravis in November 2018 , under goes to thyimactimy in February so he is taking steroids and amegra till now. But he is dignose with dengue in dengue NS test and his plateates is 250000 at time moment. A general physician recommend to do Dengue Elisa test.
Can someone give little guidance here?
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