局所コルチコステロイド注射の合併症

Complications of local corticosteroid injections.

• N L Gottlieb
• W G Riskin

抄録

微結晶コルチコステロイド局所注射に関連した異常な合併症が、多様なリウマチ性疾患を有する4人の患者で観察された。(3) 関節リウマチ患者における手首背側関節包摘出術後の手根管感染症；(4) 乾癬と関節炎患者における皮内コルチコステロイド注射後の顔面、頸部、胸部の顕著な紅潮。この論文では、これらの予期せぬ効果の発現の原因となる可能性のあるコルチコステロイドの生理的作用について考察している。

Unusual complications associated with local microcrystalline corticosteroid injections were observed in four patients with diverse rheumatic disorders. Adverse reactions included (1) bilateral digital flexor tendon rupture following carpal tunnel injection for idiopathic median nerve compression syndrome; (2) bowstring deformity of a finger after local corticosteroid treatment of psoriatic digital flexor tendonitis; (3) carpal tunnel infection following dorsal arthrocentesis of a wrist in a patient with rheumatoid arthritis; and (4) pronounced flushing of the face, neck, and chest after intrasynovial corticosteroid injection in a patient with psoriasis and arthritis. This article considers some physiologic actions of corticosteroids possibly responsible for development of these untoward effects.