Dexamethasone-Induced Bradycardia in a Nigerian Child:A Case Report

Abstract

Hypertension, hyperglycaemia and weight gain are some of the common side effects of corticosteroids such as dexamethasone. This case report highlights bradycardia, one of the under-reported side effects of dexamethasone in the paediatric population. We report the case of an 11-year-old boy with a left frontal open depressed skull fracture following a road traffic accident who had cranial surgery. His admitting pulse rate was 104bpm. Post-operatively, he developed laryngeal oedema necessitating intravenous dexamethasone. Thereafter, the heart rate declined to 56 bpm, and a 12-lead ECG confirmed sinus bradycardia. The heart rate returned to normal following dose reduction and the eventual discontinuation of dexamethasone. While bradycardia may be asymptomatic and reversible, there is a need for adequate monitoring as it may compromise the haemodynamic status of a sick child and worsen the outcome. Therefore, this report is important for creating awareness, prompting early detection of this side effect of dexamethasone use, and enabling appropriate intervention.