Abnormal Uterine Bleeding Following Lumbar Epidural Corticosteroid Injections and Facet Medial Branch Blocks in Both Pre- and Postmenopausal Women: A Case Series: Table 1

Hirsch, Jason G.; Hsu, Eric S.

doi:10.1111/j.1526-4637.2012.01445.x

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…Vaginal bleeding has been reported as a potential complication of ESI [ 99 , 101 ]. Suh-Burgmann et al [ 116 ] have retrospectively reviewed 8166 ESI procedures and reported an incidence of 2.5 % ( n = 201; 197 patients) for abnormal vaginal bleeding [ 116 ].…”

Section: Resultsmentioning

confidence: 99%

Safety of Epidural Corticosteroid Injections

et al. 2015

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Background and ObjectiveEpidural corticosteroid injections (ESIs) have been used for several decades and now represent the most common intervention performed for the management of back pain with a radicular component. However, several reports have presented devastating complications and adverse effects, which fuelled concerns over the risk versus clinical effectiveness. The authors offer a comprehensive review of the available literature and analyse the data derived from studies and case reports.MethodsStudies were identified by searching PubMed MEDLINE, Ovid MEDLINE, EMBASE, Scopus, Google Scholar and the Cochrane Library to retrieve all available relevant articles. Publications from the last 20 years (September 1994 to September 2014) were considered for further analysis. Studies selected were English-language original articles publishing results on complications related to the technique used for cervical and lumbar ESIs. The studies had to specify the approach used for injection. All studies that did not fulfil these eligibility criteria were excluded from further analysis.ResultsOverall, the available literature supports the view that serious complications following injections of corticosteroid suspensions into the cervical and lumbar epidural space are uncommon, but if they occur they can be devastating.ConclusionsThe true incidence of such complications remains unclear. Direct vascular injury and/or administration of injectates intra-arterially represent a major concern and could account for the vast majority of the adverse events reported. Accurate placement of the needle, use of a non-particulate corticosteroid, live fluoroscopy, digital subtraction angiography, and familiarisation of the operator with contrast patterns on fluoroscopy should minimise these risks. The available literature has several limitations including incomplete documentation, unreported data and inherent bias. Large registries and well-structured observational studies are needed to determine the true incidence of adverse events and address the safety concerns.

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Section: Resultsmentioning

confidence: 99%

Safety of Epidural Corticosteroid Injections

et al. 2015

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“…Among them, 6 cases were pre- and postmenopausal women who developed AUB after lumbar and sacral epidural injection of glucocorticoids to control neurological pain. 4 , 5 The other cases included allergic patients who developed AUB following the application of triamcinolone acetonide. 6…”

Section: Discussionmentioning

confidence: 99%

“…Finally, as a result of decreased secretion of ovarian estrogen and progesterone, AUB would occur. 4 , 5 , 7 , 9 …”

Section: Discussionmentioning

confidence: 99%

Abnormal uterine bleeding induced by glucocorticoid treatment for pemphigus

Hong

Jiang

Chen

2016

SMJ

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Glucocorticoids are the first-line treatment option for pemphigus. Moreover, abnormal uterine bleeding (AUB) is a rarely reported side effect of glucocorticoid treatment that usually manifests as abnormal and excessive endometrial bleeding; in fact, AUB can be induced by the systemic or topical application of glucocorticoids. In the present report, we describe the cases of 3 patients with pemphigus who developed AUB following glucocorticoid administration. It is important to note that the administration mode of glucocorticoids, and the onset time and duration of AUB differed among these patients. Thus, we propose the following treatment algorithm for AUB following glucocorticoid administration: 1. perform a gynecological and physical examination to exclude organic diseases. 2. continue glucocorticoid treatment. 3. if AUB persists, change the mode of administration of glucocorticoids. 4. if AUB still persists, despite these measures, completely withdraw treatment with glucocorticoids and use non-glucocorticoid treatments.

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“…Hirsch and Hsu [8] described a case series of 4 patients, 2 premenopausal and 2 postmenopausal women, who experienced abnormal vaginal bleeding after an ESI. The 2 patients who were postmenopausal and experienced bleeding after ESI also were undergoing hormone‐replacement therapy.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Uterine Bleeding in a Postmenopausal Woman After an Intra‐articular Knee Injection With Triamcinolone: A Case Report

James

Carneiro

2014

PM&R

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A 71-year-old postmenopausal woman was referred for evaluation of pain in her left knee. She was previously treated with oral analgesics, but her knee pain persisted, limiting her functional mobility. An intra-articular corticosteroid injection of the left knee was administered. Several days after the injection, she reported vaginal bleeding that resolved spontaneously after 5 days. We postulate that exogenous steroids disrupted circulating hormone levels, leading to abnormal postmenopausal uterine bleeding.

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Abnormal Uterine Bleeding Following Lumbar Epidural Corticosteroid Injections and Facet Medial Branch Blocks in Both Pre- and Postmenopausal Women: A Case Series: Table 1

Cited by 8 publications

References 17 publications

Safety of Epidural Corticosteroid Injections

Safety of Epidural Corticosteroid Injections

Abnormal uterine bleeding induced by glucocorticoid treatment for pemphigus

Abnormal Uterine Bleeding in a Postmenopausal Woman After an Intra‐articular Knee Injection With Triamcinolone: A Case Report

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