Re-evaluation of the Role of Corticosteroids in Extrapulmonary ARDS Following Peptic Ulcer Perforation

It is a common belief among clinicians that corticosteroid therapy is an etiologic factor in peptic ulcer disease and its complications.However, this belief is based largely on older studies, and many clinicians avoid using these agents in such patients.Nevertheless, complex clinical situations may arise in which both indications for and concerns about corticosteroid use coexist.Although corticosteroids are often considered risky or relatively contraindicated in patients with peptic ulcers, they may be indicated in the treatment of acute respiratory distress syndrome (ARDS).Here, we report a case of extrapulmonary ARDS secondary to peptic ulcer perforation that was successfully treated with corticosteroids.The patient received methylprednisolone at a dose of 1 mg/kg/day and was successfully treated and discharged without complications.Because of the widespread belief that corticosteroid therapy is contraindicated in peptic ulcer disease, few recent studies have addressed this issue.This case may renew interest in the presumed ulcerogenic effects of corticosteroids in peptic ulcer disease and its complications, thereby encouraging further research.