THE ADVERSE EFFECT of continuously-administrated steroids on the retention of nitrogen is well-documented. In balance studies on children with acute rheumatic fever,1 increased urinary nitrogen excretion often became quickly offset by the hyperorexic effect of the hormone. The effect on calcium balance has not been a consistent one. In general, fecal losses increase, although with high dietary intake, these do not necessarily result in negative calcium balance.2 In the study of Levin et al,3 both fecal and urinary calcium excretion increased when corticotropin was administered. We did not observe a consistent effect on the urinary calcium, but the fecal calcium output regularly increased. Harrison4 has demonstrated in the isolated gut loop, a decrease in the diffusion of calcium across the intestinal mucosa effected by steroids which was antagonized by vitamin D. We have observed two instances of collapsed vertebral bodies in children with rheumatoid arthritis treated
Johnston JA, Manson G, Meyer R, Whitten C, Guillemette ME. Intermittent Steroid Therapy in Nephrosis: Effect on Nitrogen and Calcium Balances. Am J Dis Child. 1967;114(3):288–291. doi:10.1001/archpedi.1967.02090240102008
Monkeypox Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.