Summary
The hypothalamic-pituitary-adrenal (HPA) axis function of eight patients with rheumatoid arthritis receiving regular intra-articular methyl prednisolone acetate was studied. Tests of the HPA axis 5–7 weeks after the last injection revealed suppression in two patients. Some patients receiving intra-articular corticosteroids may therefore have abnormal responses to stress.
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References
Chandler, G.N., Wright, V. Deleterious effects of intra-articular hydrocortisone. Lancet 1958, 2, 661–663.
Chandler, G.N., Jones, D.T., Wright, V., Hertfall, S.J. Charcots' artropathy following intra-articular hydrocortisone. Br med J 1959, 1, 952–953.
Steinberg, C., Duthie, R.B., Priva, A.E. Charcotlike arthropathy following intra-articular hydrocortisone injections. JAMA 1962, 181, 851–854.
Bentley, G., Goodfellow, J.W. Disorganisation of the knees following intra-articular hydrocortisone injections. J. Bone Joint Surg 1969, 51B, 498–502.
Balch, H.W., Gibson, J.M.C., El-Ghobarey, A.F., Bain, L.S., Lynch, M.P. Repeated corticosteroid injections into knee joints. Rheumatol Rehabil 1977, 16, 137–140.
Shushter, S., Williams, I.A. Adrenal suppression due to intra-articular corticosteroid therapy. Lancet 1961, 2, 171–172.
Bain, L.S., Jacomb, R.G., Wynn, V. Parenteral administration of 6 methyl prednisolone-21-acetate. Part II-absorption and duration of effect. Ann Phys Med 1967, 9, 49–54.
Koehler, B.E., Urowitz, M.B., Killinger, D.W. The systemic effect of intra-articular corticosteroids. J. Rheumatol 1974, 1, 117–125.
Bird, H.A., Ring, E.F.J., Bacon, P.A. A thermographic and clinical comparison of three intra-articular steroid preparations in rheumatoid arthritis. Ann Rheum Dis 1979, 38, 36–39.
Armstrong, R.D., English, J., Gibson, J., Chakrabarty, J., Marks, V. Serum methyl prednisolone levels following intra-articular injection of methyl prednisolone acetate. Ann Rheum Dis 1981, 40, 571–574.
Ropes, M., Bennett, J., Cobb, S., Jacox, R., Jessar, R.A. Revision of diagnostic criteria for rheumatoid arthritis. Arthritis Rheum 1958, 2, 16–20.
Mattingly, D. A simple flurometric method for the estimation of free 11; hydroxycorticosteroids in human plasma. J Clin Pathol 1962, 15, 374–379.
James, V.H.T., Landon, J. Hypothalamic-pituitary-adrenal function tests. Published by CIBA Laboratories 1976, 72.
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Reid, D.M., Patel, S., Reid, I.W. et al. Hypothalamic-pituitary-adrenal (HPA) axis function in patients receiving long-term intra-articular corticosteroids. Clin Rheumatol 2, 159–161 (1983). https://doi.org/10.1007/BF02032173
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DOI: https://doi.org/10.1007/BF02032173