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Secondary Adrenal Insufficiency due to Intra-articular Glucocorticoid Injections

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Abstract

Background

The most common cause of hypothalamic-pituitary-adrenal axis suppression is systemic glucocorticoids administration.

Case characteristics

A 14- year-old boy with juvenile idiopathic arthritis receiving repeated intra-articular steroids for last 3 years developed fever, fatigue, nausea and abdominal pain. Stimulation with lowdose Synathen revealed low adrenal reserve, suggesting secondary adrenal insufficiency.

Outcome

Temporary hydrocortisone substitution therapy improved condition.

Message

Intra-articular steroids may cause potentially life-threatening suppression of the hypothalamic-pituitary-adrenal axis.

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Authors and Affiliations

  1. Department of Pediatric and Adolescent Endocrinology, Institute of Pediatrics, Jagiellonian University Medical College, Children’s University Hospital, Krakow, Poland

    Malgorzata Wojcik, Anna Ruszala, Dominika Janus & Jerzy B Starzyk

Authors
  1. Malgorzata Wojcik
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  2. Anna Ruszala
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  3. Dominika Janus
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  4. Jerzy B Starzyk
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Corresponding author

Correspondence to Malgorzata Wojcik.

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Wojcik, M., Ruszala, A., Janus, D. et al. Secondary Adrenal Insufficiency due to Intra-articular Glucocorticoid Injections. Indian Pediatr 56, 242–243 (2019). https://doi.org/10.1007/s13312-019-1507-5

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  • DOI: https://doi.org/10.1007/s13312-019-1507-5

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