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Arch Intern Med. 2001;161:1778-1779.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

High-dose intravenous glucocorticoid pulse therapy (0.5-1.0 g) is frequently used to initiate therapy in patients with rapidly progressive, immunologically mediated diseases. Previous observations showed a relatively high number of adverse effects, including cardiotoxicity. Garrett and Paulus¹ noticed adverse effects in 56% of patients with rheumatoid arthritis (RA), systemic lupus erythematosus, polymyositis, and dermatomyositis who were receiving intravenous high-dose methylprednisolone therapy. Fatal arrhythmias, cardiac arrest, severe bradycardia, atrial fibrillation, and ventricular arrhythmias have been reported in the course of and in the days after 1 high-dose glucocorticoid treatment.^2-3 Recent studies have shown the effectiveness and greater safety of the methylprednisolone "minipulse" treatment. We describe 2 patients who had bradycardia in association with a series of minipulse methylprednisolone treatments (125 mg/d).

Report of Cases

Case 1

A 28-year-old woman with IgM rheumatoid factor seropositive RA according to 1987 American College of Rheumatology criteria for RA was admitted for treatment of the active form of the disease (morning . . . [Full Text of this Article]

Case 2

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