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Steroid­injektion i kombination med hivläkemedel gav total binjure­barkssvikt
Engelsk titel: One steroid injection in combination with HIV-medication resulted in a total adrenal insufficiency Läs online Författare: Rössner, Sophia ; Höybye, Charlotte Språk: Swe Antal referenser: 19 Dokumenttyp: Fallbeskrivning UI-nummer: 18040285

Tidskrift

Läkartidningen 2018;115(15)666-7 ISSN 0023-7205 E-ISSN 1652-7518 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

Sammanfattning

This case report describes a woman living with HIV on treatment including ritonavir-boosted darunavir, who suffered complete secondary adrenal insufficiency after a single intra-articular injection of the corticosteroid triamcinolone. There is a known pharmacological interaction between ritonavir and those corticosteroids which are metabolised by the CYP3A4 pathway. This interaction may lead to complete adrenal insufficiency, which is a life-threatening condition. Adrenal insufficiency must be promptly diagnosed and hydrocortisone replacement started. People living with HIV should be on lifelong antiretroviral treatment, and corticosteroids are common in the treatment of many different conditions seen by various specialists. This case highlights that not only physicians engaged in HIV treatment need to be aware of this important interaction.