Corticosteroids (prednisone)

Broad immunosuppression; reduces complement activation and neutrophil recruitment

Response rate
Initial response in most, frequent relapse on taper
Onset
Days
Route
Oral prednisone 0.5-1 mg/kg/day
Line
1st
IgM effect
Partial complement normalization during treatment

Evidence summary

Corticosteroids are the mainstay of acute management for moderate-to-severe HUVS. They suppress systemic inflammation and can normalize complement levels temporarily. However, most patients relapse on taper, requiring steroid-sparing agents for maintenance. Long-term use limited by side effects.