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) bone mineral density (BMD)
(2) steroid myopathy
(3) body mass index in kg per square meter
(4) growth velocity
Parameter
Finding
Points
bone mineral density
increase > 0.5
-32
no change (+/-- 0.5)
0
decrease > 0.5
32
steroid myopathy
moderate weakness to none
-41
moderate weakness to minor
-29
minor weakness to none
-12
no change
0
no weakness to minor
12
minor weakness to moderate
29
no weakness to moderate
41
body mass index
decrease by >= 5
-52
decrease by 2.01 to 4.99
-21
no change (+/- 2)
0
increase by 2.01 to 4.99
21
increase by >= 5
52
growth velocity
increase in z-score > 0.5
-49
no change in z-score (+/-- 0.5)
0
decrease in z-score > 0.5
49
subscore for musculoskeletal effects =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: -174
• maximum score: 174
• The higher the score the greater steroid impact.
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