Letter: Acute arthralgia following high-dose intravenous methylprednisolone therapy.

SIR,-Withdrawal symptoms following the cessation of long-term steroid therapy are well known. These include exacerbation of prior symptoms such as recurrence of arthritis and arthralgia in the rheumatoid patient, or fever, myalgia, hypotension, anorexia, nausea, lethargy, and desquamation of the skin. In severe cases, signs and symptoms of acute adrenal insufficiency may also occur. Over the past two years we have observed a new group of severe withdrawal symptoms in kidney-transplant recipients. These occurred in patients who were already receiving maintenance doses of prednisone and, in addition,