OBJECTIVE: To assess the effect on endogenous cortisol production of administration of intraarticular steroids for chronic arthritis in children and adolescents. METHODS: We examined 22 children with chronic arthritis who received intraarticular steroid injection. The morning peak cortisol concentration was measured in saliva before and several days to weeks after steroid injection. In 7 children cortisol concentrations were measured at 4 pm and 8 pm as well. In one girl the hypothalamic-pituitary-adrenal axis was tested using the corticotropin releasing hormone stimulation test. RESULTS: After steroid injection there was suppression of endogenous cortisol production that lasted 10 to 30 days. During this period the circadian rhythm of cortisol production and the hypothalamic-pituitary-adrenal axis were disturbed. CONCLUSION: After intraarticular steroid injection children show transient suppression of endogenous cortisol production. It is not known whether this might place them at risk from stress induced acute adrenal insufficiency.
OBJECTIVE: To assess the effect on endogenous cortisol production of administration of intraarticular steroids for chronic arthritis in children and adolescents. METHODS: We examined 22 children with chronic arthritis who received intraarticular steroid injection. The morning peak cortisol concentration was measured in saliva before and several days to weeks after steroid injection. In 7 childrencortisol concentrations were measured at 4 pm and 8 pm as well. In one girl the hypothalamic-pituitary-adrenal axis was tested using the corticotropin releasing hormone stimulation test. RESULTS: After steroid injection there was suppression of endogenous cortisol production that lasted 10 to 30 days. During this period the circadian rhythm of cortisol production and the hypothalamic-pituitary-adrenal axis were disturbed. CONCLUSION: After intraarticular steroid injection children show transient suppression of endogenous cortisol production. It is not known whether this might place them at risk from stress induced acute adrenal insufficiency.
Authors: Ashley P Jones; Dannii Clayton; Gloria Nkhoma; Frances C Sherratt; Matthew Peak; Simon R Stones; Louise Roper; Bridget Young; Flora McErlane; Tracy Moitt; Athimalaipet V Ramanan; Helen E Foster; Paula R Williamson; Samundeeswari Deepak; Michael W Beresford; Eileen M Baildam Journal: Health Technol Assess Date: 2020-07 Impact factor: 4.014