The Effect of Methotrexate as An Alternative Therapy in Cushing Syndrome Induced by Methylprednisolone in Multibacillary Morbus Hansen with Erythema Nodosum Leprosum
DOI:
https://doi.org/10.37287/ijghr.v8i4.1956Keywords:
cushing syndrome, erythema nodosum leprosum, methotrexate, methylprednisolone, morbus hansenAbstract
Long-term high-dose corticosteroid therapy in Erythema Nodosum Leprosum (ENL) and Multibacillary Morbus Hansen (MB-type MH) can cause side effects, one of which is Cushing's Syndrome. A 25-year-old male patient with ENL and MB-type MH experienced Cushing's Syndrome due to a history of treatment with oral methylprednisolone 32 mg/day for 1 year with supervision as a management of his disease. Management during hospitalization with Multidrug Treatment-Multibacillary (MDT-MB), methotrexate 25 mg/week, folic acid 1 mg/day and topical therapy in the form of 10% urea cream twice a day. After 4 days hospitalized, this patient's condition improved. Methotrexate is a therapeutic option for ENL because of its anti-inflammatory mechanisms that specifically target the pathogenic pathways that cause ENL, especially inflammation and cytokine storm caused by neutrophils. Administration of methotrexate as an alternative therapy in treating ENL and MB-type MH with Cushing's syndrome can be considered.
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