Plasma levels of several amino acids are increased in preterm infants after several days of treatment with dexamethasone. Acute effects, however, have not been published. We measured plasma amino acid levels immediately before (day 0), 24 hours after and 48 hours after starting treatment with dexamethasone (0.6 mg/kg/day, twice daily) in, 8 preterm infants (gestational age 26-29 weeks, birthweight 790-1485 grams) with bronchopulmonary dysplasia. Protein intake ranged from 1.1 to 2.9 g/kg/d. At 24 hours a substantial rise of nearly all amino acids was found. There was no relationship of protein intake on consecutive days or between individuals and rise in amino acid levels. Results are summarized in the table. ALA=alanine, GLU=glutamate, GLN=glutamine, LEU=leucine, ILE=isoleucine, VAL=valine, EAA=essential amino acids, TAA=total aminoacids. Data are shown as median, (range); fractional rise at 24 and 48 hours are given. CONCLUSION: These results indicate that immediately following dexamethasone treatment protein catabolism occurs, presumably by an increased breakdown of muscle protein.