Two children, one with renal manifestations of systemic lupus erythematosus and the other with idiopathic nephrotic syndrome, were treated with methylprednisolone pulses. Neither had previous evidence of underlying cardiac disease. Within 24 h of pulse therapy, they complained of palpitations and developed atrial fibrillation which reversed spontaneously or after anti-arrhythmic therapy. Subsequent serial electro-and echocardiograms were normal. We propose that the arrhythmias were a complication of steroid pulse therapy.
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