The effect of intra-articular injection of Diprospan at the knee joint on the hypothalamic-pituitary-adrenal axis
| Autor: | Ronza Najjar, Rana Zahran, Adel Jabbour, Geries Hakim, Samih Badarny, Suheil Artul, Haneen Jabaly-Habib, George Habib |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Hypothalamo-Hypophyseal System Hydrocortisone Knee Joint Anti-Inflammatory Agents Betamethasone dipropionate Pituitary-Adrenal System Adrenocorticotropic hormone Osteoarthritis Betamethasone Injections Intra-Articular Basal (phylogenetics) Internal medicine medicine Humans Aged business.industry General Medicine Middle Aged Osteoarthritis Knee medicine.disease Rheumatology Surgery Drug Combinations medicine.anatomical_structure Female business Hypothalamic–pituitary–adrenal axis medicine.drug Adrenal Insufficiency |
| Zdroj: | Swiss medical weekly. 145 |
| ISSN: | 1424-3997 |
| Popis: | Questions under study In this work we wanted to evaluate the effect of intra-articular injection (IAI) at the knee joint of 1 ml of Diprospan on the hypothalamic-pituitary-adrenal (HPA) axis. Methods Consecutive patients attending the rheumatology or orthopaedic clinic with osteoarthritic knee pain not responding satisfactorily to medical and physical therapy were asked to participate in our study. After consent, patients had ultrasound-guided IAI of 1 ml of Diprospan, containing 2 mg of betamethasone sodium phosphate and 5 mg of betamethasone dipropionate. Demographic, clinical, laboratory and radiographic variables were documented. Just prior to the knee injection and 1, 2, 4 and 6 weeks later, patients had a 1-µg adrenocorticotropic hormone (ACTH) stimulation test. Secondary adrenal insufficiency (SAI) was defined as a poststimulation (30 minutes after ACTH injection) serum cortisol level of less than 18 µg/dl (~500 nmol/l) and lack of a rise of >6 µg/dl (~166 nmol/l) over the basal level in poststimulation serum cortisol. Results Twenty patients completed the study. There were 3 male and 17 female patients, with a mean age of 58.6±9.5 years. Six (30%) patients had evidence of SAI and in five of them it was seen at one time-point, mostly at week 2 after the IAI. In one patient, SAI was prolonged and observed from week 1 to week 4. Conclusions IAI at the knee joint of 1 ml of Diprospan was associated with a transient high rate of SAI. |
| Databáze: | OpenAIRE |
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