Abstract
To the Editor.— Alternate-day corticosteroid therapy may minimize adverse effects during prolonged therapy.1The off-day of short-acting preparations diminishes hypothalamic-pituitary-adrenal suppression and deleterious effects.2,3Daily use of corticosteroids can precipitate the hyperosmolar diabetic state,2but this has not been described using the safer alternate-day regimen. The following patient experienced this complication while receiving alternate-day prednisone therapy. Report of a Case.— During May 1981 to July 1982, a 62-year-old woman experienced the development of undifferentiated connective tissue disease consisting of asymmetric erosive polyarthritis (metacarpophalangeal and proximal interphalangeal bones, wrist, midfoot, and atlanto-axial joints), anemia of chronic inflammation, glomerulonephritis, and uveitis. Results of standard blood chemistry studies (potassium range, 3.8 to 4.4 mEq/L) and thyroid tests, levels of total hemolytic complement and anti-DNA, and leukocyte and platelet counts were normal throughout her course. Antinuclear antibody was 1:80 homogeneous; rheumatoid factor was 1:160. Only one of multiple synovianalyses had possible
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