Four cases of a secondary Cushingoid state following local triamcinolone acetonide (Kenacort) injection

Intra-articular, paratendinous or other soft tissue corticosteroid injections are well-recognised treatment modalities for rheumatic conditions in which a debilitating inflammatory component persists. A corticosteroid injection that is locally administered only sporadically evokes adverse effects. We report four cases of secondary Cushingoid state, twice due to single, and twice due to repetitive triamcinolone acetonide (TCA: Kenacort) injection. A consulted general practitioner, internist and gynaecologist were not aware of the possibility that such a local injection may evoke a Cushingoid state with moon face, buffalo hump and/or disturbance of the menstrual cycle. Therefore we describe here the four cases we recently encountered.