Summary. Subject of the research: immune status of 26 patients (main group) with septic complications after local application of glycocorticoids and 17 patients (comparative group) with septic arthritis, in which the purulent inflammatory process developed due to hematogenous spread of infection of the joint and was not a complication caused by local use of glycocorticoids. Objective: to evaluate the immune status of patients of the main and comparative groups, to study the dynamics of immunological indicators before and after surgical treatment, and to determine factors which are important to predict the disease course and treatment results. Research methods: an analysis of immunological (content of lymphocytes and their subpopulations – CD3+-, CD4+-, CD8+-cells; А, М and G classes of immunoglobulins; levels of circulating immune complexes) and hematological (levels of erythrocytes, leucocytes, thrombocytes, hemoglobin, as well as erythrocyte sedimentation rate) laboratory data of both groups was conducted. Results. Disorders concerning cellular and humoral factors of immune defense as well as hematological indices were revealed. It is shown that the improvement of immune status after clearing surgical intervention and the reduction of inflammatory response in patients of the main group is slower than in the comparative group. Conclusions. Assumption was made that glycocorticoids may be a factor that deepens and prolongs the immunosuppression that patients had before their local use.

Summary. The work is devoted to the studies of immune status of patients with infectious complications after local glucocorticoid injections. Objective: to assess the state of the immune system of patients with infectious complications after local glucocorticoid injections, to monitor the dynamics of immunological parameters before and after sanitizing surgical treatment, and to reveal factors that are important for predicting the course of the disease and treatment results. Materials and Methods. The immune status of 26 patients with purulent inflammatory processes after local glucocorticoid injections in rheumatoid arthritis, deforming osteoarthritis, and chronic synovitis was studied. Immunological, hematological, and statistical research methods were used. Results. Changes of immunity factors as well as hematological parameters were revealed: a decrease in the content of T-lymphocytes (CD3+), T-helpers (CD4+), T-suppressors / cytotoxic lymphocytes (CD8+), immunoglobulins of classes A, M, and G; an increase in the levels of circulating immune complexes (СIC), the number of thrombocytes, erythrocyte sedimentation rate (ESR), and the reaction of the neutrophil leukocytes. It has been shown that the improvement of the immune status and the decrease in the level of inflammatory reactions after the sanitizing surgical intervention occurs slowly, which requires the inclusion of immunocorrective therapy in the treatment of such patients. Conclusions. Primary examination of patients before surgery for the purpose of sanitizing the infection showed that the local inflammatory process in the bones and joints occurs against the background of altered immunological and hematological parameters. Dynamic follow-up showed that we are dealing not only with a local process, but also with a systemic inflammatory response. A variant of the laboratory criterion for the course of infectious complications and the effectiveness of the treatment can be the determination in the dynamics of the content of T-lymphocytes and their subpopulations, the levels of the CIC, platelets and ESR.