Mechanism of steroid induced leukocytosis

Progestogens The discovery that ethinyl substitution leads to oral potency led to the preparation of ethisterone, an orally active derivative of testosterone. In 1951, it was found that removal of the carbon-19 from ethisterone to form norethindrone did not destroy the oral activity and, most importantly, changed the major hormonal effect from that of an androgen to that of a progestogen. Accordingly, the progestational derivatives of testosterone were designated 19-nortestosterones. The androgenic properties of these compounds, however, were not completely eliminated, and minimal anabolic and androgenic activity remains. Examples of this class of progestogens include norethindrone, norethynodrel, ethynodiol diacetate, and some other related compounds not used in the United States. The second group of 19-nor compounds are gonanes, which have an 18-ethyl instead of an 18-methyl group. They include racemic norgestrel, levonorgestrel, and three newer compounds: gestodene, desogestrel (a pro-drug that must be converted to 3-ketodesogestrel to be biologically active) and norgestimate, which is the 17-acetyl-3-oxime derivative of norgestrel, into which it is rapidly metabolized.

The rationale for the use of vitamin D derivatives in the treatment of psoriasis is based on the observation that patients with hypocalcemia often develop various forms of psoriasis, most notably the pustular form. In one case, a patient who had undergone thyroidectomy developed repeated flares of pustular psoriasis after decreases were made in her dosage of ergocalciferol (Vitamin D 2 ); each episode was related to severe hypocalcemia and resolved after her serum calcium levels normalized. 14 Another patient with osteoporosis experienced dramatic improvement in severe psoriasis after receiving an oral form of vitamin D. 15 This finding, along with the discovery that the bioactive form of 1,25-dihydroxycholecalciferol has been shown to inhibit keratinocyte proliferation and promote keratinocyte differentiation, 16 has led to the development of vitamin D analogs for the treatment of psoriasis.

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Mechanism of steroid induced leukocytosis

mechanism of steroid induced leukocytosis

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