High dose inhaled Corticosteroids can cause Achilles Tendonitis

Abstract

Management of Chronic Obstructive Pulmonary Disease (COPD) patients involves use of inhaled steroids, which are known to reduce exacerbations and improve respiratory symptoms. Nevertheless evidence suggests that oral steroids can cause tendonitis, in particular Achilles tendonitis and rupture. Here we present a case report of a patient who had moderate COPD confirmed by spirometry and was started on inhaled steroids. Following this, the patient developed Achilles tendonitis which was confirmed by ultrasonography and further by reproduction of symptoms and signs by dechallenge/rechallenge strategy. To our Knowledge, this is the first report that demonstrates the association of inhaled steroids with tendonitis in COPD patients. While inhaled steroids might be useful in management of COPD patients; development of tendonitis as a consequence of this treatment deserves careful thought.