| Summary points: | Two HIV-positive patients, a 41-year-old man and a 42-year-old woman, present with signs and symptoms consistent with adrenal suppression after being exposed to intra-articular triamcinolone acetate while also receiving ritonavir as part of their highly active antiretroviral therapy. Symptoms, physical examination, and laboratory tests are described; image provided. The authors discuss the development of adrenal suppression as a result of increased systemic concentrations of triamcinolone due to an inhibition of cytochrome p450 3A4 metabolism. |
Adrenal Suppression Due to an Interaction Between Ritonavir and Injected Triamcinolone: A Case Report
