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When reduction in dosage is possible, the reduction should be gradual. Discontinuation of corticosteroids may result in clinical improvement.

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Signs of peritoneal irritation following gastrointestinal perforation in patients receiving corticosteroids may be minimal or absent. There is an enhanced effect due to increased metabolism of corticosteroids in patients with cirrhosis. Appropriate examination of any joint fluid present is necessary to exclude a septic process.

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