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Parenteral Steroids Prevent Adrenal Collapse

JAMA. 1964;188(7):29. doi:10.1001/jama.1964.03060330091045.
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ABSTRACT

Reluctance on the part of family physicians to give parenteral steroids to patients with the salt-losing form of the adrenogenital syndrome was scored by two Philadelphia pediatricians at the Hahnemann Symposium on anabolism and catabolism May 4 and 5.

"It has been the experience of all who care for patients with this disease that family physicians are reluctant to give parenteral steriods, and as a result the patient succumbs to irreversible adrenal collapse," Harvey D. Klevit, MD, told the symposium audience.

"It cannot be emphasized enough how thin a thread separates an individual with the salt-losing form of the disease from complete adrenal failure and collapse," he added.

The salt-losing form occurs in about one third of all patients with the disease, Klevit said. In these patients severe sodium loss leads to the rapid onset of hyponatremia, shock, and death. Vomiting, dehydration, and occasionally diarrhea generally appear between the second

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