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High dose corticosteroids short term: how will they affect tests?

May 16, 2004

Thank you for your very valuable service on this forum.

I have two quick questions and hope you can help: I am on high doses of Dexamethasone this week (2mg 4 times per day)for endocrine testing.

a. What effect could this have on my VL (usually nondetectable, sometimes <6,000) and CD4 counts..and how long should I wait to have my due VL and T cell subset to be 100 percent sure that the Dexamethasone has cleared my system and bloodowrk is back to normal?

b. I have a scan on Tuesday for muscle inflammation, with biospies if needed...could the high doses of Dexamethasone and possible high levels of cortisol to begin with affect the scan and biopsies? I mean, if Dexamethasone and natural cortisol are anti-inflammatories, wouldn;t this increase the chance of fasle negative scan and biopsies? If so, how long would you advise I wait after stopping the Dexamethasone for a reliable scan and biopsies? I raised this concern with the office of the doctor who is doing the scan and was told that he didn;t think the Dexamethasone was an issue...but I still wonder how high does anti- inflammatories could not potentially affect testing for inflammation... I would appreciate your perspectives.

Thank you.

Response from Dr. Holodniy

a. There is no data to answer this question. It would be advisable to wait about a month after finishing the steroid. b. I don't think the short term course of steroids would affect the overall picture in a muscle biopsy.

Lab results: very high cortisol...caused by HIV itself?

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