The major adverse effect of glucocoicoids especially in children is ?
**Core Concept**
Glucocorticoids are a class of steroid hormones that have potent anti-inflammatory and immunosuppressive effects. However, their long-term use can lead to several adverse effects, particularly in children, due to their impact on growth and development.
**Why the Correct Answer is Right**
The major adverse effect of glucocorticoids in children is growth suppression. This occurs because glucocorticoids inhibit the growth hormone axis, leading to a decrease in insulin-like growth factor-1 (IGF-1) production. IGF-1 is essential for bone growth and development, and its suppression results in stunted growth and delayed puberty. This effect is most pronounced in children, especially during the first two years of life, when the growth plate is most active.
**Why Each Wrong Option is Incorrect**
**Option A:** Glucose intolerance is a well-known side effect of glucocorticoids, but it is not the major adverse effect in children. While glucocorticoids can lead to hyperglycemia and diabetes mellitus, this effect is more common in adults.
**Option B:** Hypokalemia is a potential side effect of glucocorticoids, but it is not the major adverse effect in children. Glucocorticoids can lead to potassium loss, but this effect is more common with mineralocorticoid activity, not glucocorticoid activity.
**Option C:** Hypertension is a potential side effect of glucocorticoids, but it is not the major adverse effect in children. While glucocorticoids can lead to fluid retention and hypertension, this effect is more common in adults and is not as pronounced in children.
**Clinical Pearl / High-Yield Fact**
The growth-suppressing effect of glucocorticoids in children is dose-dependent and can be minimized with low-dose therapy and careful monitoring of growth parameters.
**Correct Answer: B. Hypokalemia.**