Tachon’s syndrome (suracute back and/or thoracic pain following local injections of corticosteroids). A report of 318 French cases - 01/01/00
Jean-Marie Berthelot * , Laetitia Tortellier, Pascale Guillot, Alain Prost, Jean-Pierre Caumon, Joëlle Glemarec, Yves MaugarsThe SRO (Société de Rhumatologie de l’Ouest)*Corresponding author.
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Résumé |
Objectives. - To assess the frequency, features, and outcome of excruciating lumbar, dorsal, and/or thoracic pain following injections of local corticosteroids in rare instances.
Methods. - A questionnaire mailed to 500 French rheumatologists.
Results. - Three hundred and eighteen cases were reported by 92 rheumatologists (one event per 8000 injections or 6.5 years of practice), following injections into lumbar epidural space (39%), an upper limb (30%), a lower limb (mostly the heel) (24%), or other locations (7%), of cortivazol (67%), hydrocortisone (25%), betamethasone (7%), or paramethasone (1%). Symptoms occurred 1-5 min (78%) or less than 1 min (22%) after injection, and highly acute axial pain usually lasted for less than 5 min (34%) or 5-15 min (51%). In addition to pain in lumbar (84%) and/or dorsal regions (25%) [often preceded or associated with thoracic pain (36%)], other signs were: anxiety (87%), shortness of breath (64%), facial flushing (64%), diffuse sweating (41%), agitation (29%), transient cough (23%), abdominal pain (20%), transient hypertension (15%), paleness (10%), hypotension (8%), diarrhoea (3%) and headache (3%). None of these patients was known to be allergic, and urticaria developed in only 2%. Outcome was favourable in all cases (even though 4/318 patients were transiently hospitalised) with an overall duration of 25 ± 71 min. Another injection was performed later in 146/318 cases (46%), but Tachon’s syndrome recurred in only 20 of these 146 patients (14%).
Conclusion. - The outcome of this impressive syndrome seems excellent. Tachon’s syndrome might be the venous counterpart of Nicolau’s syndrome (injection of corticosteroids in an artery).
Mots clés : Corticosteroid ; Injections ; Side-effects ; Toxicity ; Nicolau ; Back pain.
Plan
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P. 66-68 - décembre 2000 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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