Sarcoidosis

Prednisone

02/12/2008 11:39AM

Question:

I`ve been on prednisone for almost 4 yrs for sarcoidosis (now also cardiac). I also take MTX subq weekly in the hopes that I can begin decreasing my pred but so far my heart starts skipping and I have to go back up on the pred. I am so puffy, on 3 different insulins (was not diabetic before pred), gained a lot of wt, etc. I am grateful for the pred b/c know I would be in serious trouble if not for it but the side effects can be horrendous. My question: what is it about the prednisone that can make a person so puffy? My face doesn`t look at all like my drivers license photo...my neck is huge with a double chin, my belly large, the top part of my back has a hump. I am 50 yrs old and I feel like I`m 90.

Answer:

Dear Sir/Madam-
The experience you are having with prednisone is typical of someone who is taking a relatively large dose for a long period of time. Sometimes methotrexate can reduce the need for prednisone, and there are a few other options if that doesn't work. Prednisone increases hunger (more food intake) and causes the accumulation of fat in the face, neck and trunk regions. It also causes thinning of the skin, salt retention (swelling), cataracts, weakening of the bones and problems with blood sugar control in diabetics. As you say, prednisone works very well to control the disease, but the side effects that one has to endure can be many.
As we learn more about what causes sarcoidosis, we hope to come up with better treatment options.

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Response by:

Elliott D. Crouser, MD
Assistant Professor
Pulmonary, Allergy, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
The Ohio State University