Abstract

THE deleterious effect of steroid therapy on nitrogen and calcium metabolism is well known. A previous paper 1 reported balance data on these two items in children being treated with corticotropin or steroids for acute rheumatic fever. The effect on nitrogen is fairly consistent, urinary excretion rising due to increased protein catabolism. 2 This effect did not consistently result in negative nitrogen balances, since it was usual to find the increased losses more than offset by marked increases in intake with improved appetites. The effects on calcium were not consistent. In general, fecal losses increased and there was a tendency for negative balances to occur. This was frequently not observed in children who presumably had diminished reserves from inadequate intakes before being studied. Since the earlier study, we have explored methods by which negative balances might be averted. The present report concerns 27 acute rheumatic fever patients of 31 patients

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