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First requirement is for techniques that are as comprehensive as possible for metabolic analyses. The anabolic steroid abuse and appropriate referral for treatment is highly warranted.

Once control is again established alternate day therapy may be reinstituted. If a person is deficient in 21-hydroxlyase, the steroid pathway converting progesterone to deoxycorticosterone will be unable to continue. Sheppard, MD, MMSc, can be reached at Virginia Eye Consultants, 241 Corporate Blvd.

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