Brogan et al reported the Pediatric Glucocorticoid Toxicity Index (pGTI). This is based on the Glucocorticoid Toxicity Index (GTI). The authors are from multiple institutions in England, the United States and Canada.
Patient selection: <= 18 years old on glucocorticoids
Parameters:
(1) glucose metabolism
(2) blood pressure
(3) lipid metabolism
Parameter
Finding
Points
glucose metabolism
improvement in HbA1c AND decrease in medication
-40
decrease in medication without improvement in HbA1c
-29
improvement in HbA1c without decrease in medication
-17
no significant change
0
increase in HbA1c without decrease in medication
17
increase in medication without increase in HbA1c
29
increase in HbA1c AND increase in medication
40
blood pressure
improvement in blood pressure AND decrease in medication
-38
decrease in medication without improvement of blood pressure
-26
improvement in blood pressure without decrease in medication
-15
no significant change
0
increase in medication without increase in blood pressure
15
increase in blood pressure without increase in medication
26
increase in blood pressure AND increase in medication
38
lipid metabolism
decrease in LDL AND decrease in medications
-33
decrease in medication without decrease in LDL
-22
decrease in LDL without decrease in medication
-11
no significant change
0
increase in LDL without increase in medications
11
increase in medications without increase in medications
22
increase in LDL AND increase in medication
33
subscore for metabolic and cardiovascular effects =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: -111
• maximum score: 111
• The higher the score the greater the metabolic and cardiovascular effects.
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