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Prevalence Clinical features Differential Diagnosis Investigations Therapy Prognosis

Therapy Give corticosteroids a  immediately in all suspected cases d   Start with 40 mg prednisolone d daily a   with vitamin D and calcium supplements. a Warn patients they may be on steroids for a long time, and that side-effects are common with long-term use. a   Common problems include weight gain and vertebral fractures. d   Watch out for iatrogenic Cushing's syndrome, bacterial sepsis and hypertension. a   Consider starting antacid medication if patients complain of dyspepsia d bisphosphonates a  weekly methotrexate a   There is no clear benefit from combining steroids with  azathioprine a

Expiry date: January 2004
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