{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:32:39Z","timestamp":1776825159145,"version":"3.51.2"},"reference-count":38,"publisher":"Walter de Gruyter GmbH","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2020-0219_abs_001_w2aab3b7c52b1b6b1aab1c15b2Aa\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Intra-articular and\/or periarticular corticosteroid injection (IACI) is a common procedure in pediatric rheumatology. Despite many adult studies demonstrating a significant risk of adrenal insufficiency (AI) following the procedure, very little evidence is available in the pediatric literature regarding this risk. The main goal of this study is to evaluate the prevalence of AI in children with chronic arthritis following IACI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0219_abs_002_w2aab3b7c52b1b6b1aab1c15b3Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a retrospective study including children aged 0-18 years who had an IACI from June 2017 to July 2019. An 8:00 morning cortisol (8MC) sample was drawn around two weeks after the injection, and an ACTH 1mcg stimulation test was performed if morning cortisol level was low. AI was defined as an 8MC under 50\u00a0nmol\/L or an abnormal ACTH stimulation test. Risks factors for AI and its duration were assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0219_abs_003_w2aab3b7c52b1b6b1aab1c15b4Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sixty patients were included in this study. AI prevalence was 30% with 18 of 60 affected patients. The corticosteroid dose injected was statistically associated with the development of AI. Median duration of AI was 181 days for the nine patients who were followed up until resolution of AI. Four patients developed symptoms of AI, namely fatigue (2 of 4), nausea (2 of 4) and abdominal pain (3 of 4). None were hospitalized or died.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0219_abs_004_w2aab3b7c52b1b6b1aab1c15b5Aa\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this cohort of children with chronic arthritis who had an IACI, we found a high prevalence of AI. Monitoring and counseling of such complication is warranted until further evidence is available.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2020-0219","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T14:47:52Z","timestamp":1598626072000},"page":"1257-1263","source":"Crossref","is-referenced-by-count":2,"title":["Risk of adrenal insufficiency following intra-articular or periarticular corticosteroid injections among children with chronic arthritis"],"prefix":"10.1515","volume":"33","author":[{"given":"Justine","family":"Turmel-Roy","sequence":"first","affiliation":[{"name":"Department of Pediatrics , CHU de Qu\u00e9bec \u2013 Universit\u00e9 Laval , Qu\u00e9bec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc-Antoine","family":"B\u00e9dard","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Immunology , CHU Sainte-Justine, Montr\u00e9al University , Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maude","family":"Millette","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology , CHU de Qu\u00e9bec \u2013 Universit\u00e9 Laval , Qu\u00e9bec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Simonyan","sequence":"additional","affiliation":[{"name":"Research Institute , Laval University , Qu\u00e9bec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Philippe","family":"Proulx-Gauthier","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Rheumatology , CHU de Qu\u00e9bec \u2013 Universit\u00e9 Laval , Qu\u00e9bec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Rousseau-Nepton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Endocrinology , CHU de Qu\u00e9bec \u2013 Universit\u00e9 Laval , Qu\u00e9bec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2020,8,26]]},"reference":[{"key":"2023040101055561625_j_jpem-2020-0219_ref_001_w2aab3b7c52b1b6b1ab2b1b1Aa","unstructured":"Kliegman, RSB, St-Geme, JW, Schor, NF, Behrman, RE. 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