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Allergy Relief With Corticosteroid Injection

Before you consider this corticosteroid injection, you should be aware of the following:

Written by Joseph J. Callanan, M.D.

Temporary treatment of severe nasal allergy symptoms can be accomplished with a corticosteroid injection. It can also be effective in the treatment of asthma exacerbations. This treatment is reserved for those patients who have failed conventional therapy or who are unable to follow conventional treatment. If successful, the injections typically relieve symptoms for two-to-four weeks. If a patient continues to be exposed to allergens after that time, symptoms may recur. Most clinics require patients interested in corticosteroid injections to be fully evaluated by one of our clinicians before treatment. Due to the potential for side effects, we limit this treatment to one or two injections each year.

Before you consider this corticosteroid injection, you should be aware of the following:

  1. A corticosteroid injection is NOT an allergy shot. It is the injection of medicine which will result in the temporary relief of allergy symptoms.
  2. You may NOT receive the shot if you are diabetic, hypertensive, have a history of peptic ulcers or have an active infection.
  3. Corticosteroid injections will not be given to children.
  4. The injection will be given in the muscle of your hip. An uncommon side effect is subcutaneous atrophy. This atrophy manifests as a breakdown of the skin and underlying tissues, which may result in a permanent dimple. In some cases there may be muscle atrophy, a breakdown of muscle, which may result in an even larger indentation at the site of injection. This adverse effect is not serious, but may be significant from a cosmetic standpoint.
  5. Corticosteroids have systemic effects, the most important of which is decreased bone density (osteoporosis). The injection may also decrease the body’s ability to fight infections. It is unlikely that just one corticosteroid injection per year will place a person at risk, but this is a possibility. For more information about adverse effects, please see the complete list below.
  6. A corticosteroid injection may temporarily block your body’s ability to produce its own corticosteroids in response to stress such as a serious illness, accident or surgery. Prior to the injection, please let us know if you have a serious illness, have had an accident or anticipate surgery within the next month after you receive your injection.
  7. You should inform any healthcare provider you see that you have received a corticosteroid injection.

Adverse Effects

General: anaphylactoid reactions, aggravation or masking of infections.

Cardiovascular: hypertension, syncope, congestive heart failure, arrhythmias, necrotizing angiitis, thromboembolism, thrombophlebitis.

Fluid and Electrolyte Disturbances: sodium retention, fluid retention associated with hypertension or congestive heart failure, potassium loss which may lead to cardiac arrhythmias or ECG changes, hypokalemic alkalosis.

Musculoskeletal: muscle weakness, fatigue, myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, delayed healing of fractures, pathologic fractures of long bones, spontaneous fractures.

Gastrointestinal: peptic ulcer with possible subsequent perforation and hemorrhage, pancreatitis, abdominal distention, ulcerative esophagitis.

Dermatologic: impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, purpura, striae, hirsutism, acneiform eruptions, lupus erythematosus-like lesions, hives, rash, suppressed reactions to skin tests.

Neuropsychiatric: convulsions, increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment, vertigo, headache, insomnia, neuritis, parasthesias, aggravation of pre-existing psychiatric conditions, depression (sometimes severe), euphoria, mood swings, psychotic symptoms and personality changes.

Endocrine: menstrual irregularities, development of the cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress (e.g., trauma, surgery, or illness), decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, and increased requirements for insulin or oral hypoglycemic agents in diabetics.

Ophthalmic: posterior subcapsular cataracts, increased intra-ocular pressure, glaucoma, and exophthalmos.

Hematologic: lymphopenia, neutropenia.

Immunogical: diminished IgE levels, loss of delayed-type hypersensitivity, potential for increased risk of opportunistic infection/severe varicella infection.

Article Reviewed: June 13, 2013
Copyright © 2014 Healthy Magazine

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