Injection of steroids side effects
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Side Effects of Steroid Injections: A Comprehensive Overview
Steroid injections are commonly used for various medical conditions, but they come with a range of potential side effects. This article synthesizes findings from multiple studies to provide a clear understanding of these side effects.
Systemic Side Effects of Steroid Injections
Common Systemic Side Effects
Steroid injections can lead to several systemic side effects. A study on patients with idiopathic subglottic stenosis (iSGS) who received serial intralesional steroid injections (SILSI) reported that 55% of patients experienced side effects such as menstrual irregularities, feelings of joy, and sleeping difficulties. These side effects were generally mild to moderate and resolved after treatment completion .
Long-Term Systemic Effects
Long-term use of anabolic androgenic steroids (AAS) can result in significant systemic side effects. Research on bodybuilders using AAS showed a decrease in fertility, impaired lipid profiles, and increased cardiovascular risk. These effects included reduced levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and sex hormone-binding globulin (SHBG), as well as a significant decrease in sperm count and HDL-cholesterol levels .
Psychiatric Side Effects
Steroid injections can also cause psychiatric side effects. A case study reported an elderly woman experiencing visual hallucinations after receiving intra-articular steroid injections for suprapatellar bursitis. These hallucinations resolved without treatment within six days .
Local Complications of Steroid Injections
Injection Site Reactions
Local complications at the injection site are common. These can include tissue necrosis, soft tissue infections, and granulomatous reactions. For instance, a bodybuilder developed a large painful inflammatory mass in the gluteal area due to depot steroid injections . Another study highlighted cases of knee joint sepsis and radial nerve palsy resulting from self-administered anabolic steroid injections .
Skin and Tissue Changes
Intralesional steroid injections can cause skin changes such as hypopigmentation and atrophy. A rare case reported linear hypopigmentation and atrophy in a patient, likely due to the lymphatic spread of corticosteroid crystals .
Specific Risks with Different Types of Steroid Injections
Glucocorticoid Injections
Local glucocorticoid injections, used for joint, soft tissue, or spinal pain, can have systemic effects. These include Cushing syndrome, loss of bone density, infection, and hyperglycemia. The risk varies based on the type and dose of glucocorticoids, the number of injections, and concurrent use of oral steroids. Special caution is advised for high-risk patients, such as postmenopausal women and individuals with diabetes .
Ocular Complications
Steroid injections, even when administered far from the eye, can lead to ocular complications such as cataracts, glaucoma, and retinal emboli. Physicians should be aware of these potential side effects and inform patients accordingly .
Conclusion
Steroid injections, while effective for various medical conditions, carry a risk of both systemic and local side effects. These can range from mild and transient to severe and long-lasting. Clinicians should carefully consider these risks, especially in high-risk patients, and ensure that patients are fully informed about potential side effects before proceeding with treatment.
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