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[Case Report Comment] The inherent dangers of high-dose steroids for acute inflammatory conditions

The empirical administration of high-dose methylprednisolone was historically considered a “silver bullet” in the management of acute inflammatory conditions and exacerbations of chronic autoimmune disorders. Classic indications in the past included head trauma and spinal cord injuries, adult respiratory distress syndrome (ARDS), and fat embolism syndrome. However, more recent data from large-scale controlled randomised trials in the 21st century unveiled that high-dose steroids are indeed harmful—instead of beneficial—and associated with increased mortality in patients suffering from ARDS or traumatic brain injury.