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May 1985, Vol 139, No. 5 >
Article | May 1985

Salicylate-Induced Hepatitis in Rheumatic Fever FREE

Jahed A. Hamdan, MD; Khader Manasra, MD; Mohammed Ahmed, MD
[+] Author Affiliations

Reprint requests to Chief, Pediatrics, Pediatric Services, Dhahran Health Center, Box 76, Dhahran, Saudi Arabia (Dr Hamdan).


Am J Dis Child. 1985;139(5):453-455. doi:10.1001/archpedi.1985.02140070027021.
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• In a 4½-year retrospective study of hospitalized patients with rheumatic fever treated with salicylates, we determined that five of 34 children manifested salicylate-induced hepatitis. The average serum salicylate level in those patients with hepatotoxicity was 30.9 mg/dL, while the average serum salicylate level in the rest of the patients was 19.7 mg/dL. An awareness of this potential complication is important when treating children with salicylates at doses previously considered to be nontoxic. Serum salicylate levels should be maintained at approximately 15 to 25 mg/dL during such therapy.

(AJDC 1985;139:453-455)

REFERENCES

1 +
MacLagan T:  The treatment of acute rheumatism by Salicin . Lancet 1876;;110:222.
2 +
Sticker S:  Ueber die Resultate der Behandlung der Polyarthritis rheumatica mit Salicylsaure . Klin Wochenschr 1876;;13:1.
3 +
Schaller J:  Chronic salicylate administration in juvenile rheumatoid arthritis . Pediatrics 1978;;62( (suppl) ):916-925.
4 +
Iancu T, Elian E:  Ultrastructural changes in aspirin hepatotoxicity . Am J Clin Pathol 1976;; 66:570-575.
5 +
Hamdan J, Ahmed M, Sa'adi A:  Salicylate hepatotoxicity in rheumatic fever . Ann Trop Pediatr 1983;;3:89-91.
6 +
 Report of the ad hoc committee to revise Jones' criteria (modified) of the Council on Rheumatic Fever and Congenital Heart Disease of the American Heart Association . Circulation 1965;; 32:664-668.
7 +
Natelson S: Microtechniques of Clinical Chemistry for the Routine Laboratory . Springfield, Ill, Charles C Thomas Publisher, 1957;.
8 +
Saris NE:  Revised IFCC method for aspartate aminotransferase . Clin Chem 1978;;24:720-721.
9 +
Iancu T:  Serum transaminases and salicylate therapy . Br Med J 1972;;2:167.
10 +
Manso C, Taranta A, Nydeck I:  Effect of aspirin administration on serum glutamic oxaloacetic and glutamic pyruvic transaminases in children . Proc Soc Exp Biol Med 1956;;93:84-88.
11 +
Russell AS, Sturge RA, Smith MA:  Serum transaminase during salicylate therapy . Br Med J 1971;;2:428-492.
12 +
Rich R, Johnson J:  Salicylate hepatotoxicity in patients with juvenile rheumatoid arthritis . Arthritis Rheum 1973;;16:1-9.
13 +
Barron KS, Person DA, Brewer EJ:  The toxicity of non-steroidal anti-inflammatory drugs in juvenile rheumatoid arthritis . J Rheumatol 1982;;9:1:149-155.
14 +
Seaman WE, Ishak KG, Plotz PH:  Aspirin-induced hepatotoxicity in patients with systemic lupus erythematosus . Ann Intern Med 1974;;80: 1-8.
15 +
Levy G, Tsuchiya T, Amsel LP:  Limited capacity for salicyl phenolic glucuronide formation and its effect on the kinetics of salicylate elimination in man . Clin Pharmacol Ther 1972;;13: 258-268.
16 +
Tsuchiya T, Levy G:  Biotransformation of salicylic acid to its acyl and phenolic glucuronides in man . J Pharm Sci 1972;;61:800-801.
17 +
Levy G, Yaffe S:  Clinical implications of salicylate-induced liver damage . AJDC 1975;;129: 1385-1386.
18 +
Bell CL, Schur PH:  Juvenile rheumatoid arthritis and salicylate related liver chemistry abnormalities: Clinical and genetic considerations . Arthritis Rheum 1979;;22:592.
19 +
Disciascio G, Taranta A:  Rheumatic fever in children . Am Heart J 1980;;99:635-656.
20 +
Makela A, Yrjana T, Mattila M:  Dosage of salicylates for children with juvenile rheumatoid arthritis . Acta Pediatr Scand 1979;;68:423-430.
21 +
Levinson JE, Baum J, Brewer EJ Jr, et al:  Comparison of toletin sodium and aspirin in the treatment of juvenile rheumatoid arthritis . J Pediatr 1977;;91:799-804.
22 +
Doughty R, Giesecke L, Athreya B:  Salicylate therapy in juvenile rheumatoid arthritis . AJDC 1981;;134:461-466.

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References

1 +
MacLagan T:  The treatment of acute rheumatism by Salicin . Lancet 1876;;110:222.
2 +
Sticker S:  Ueber die Resultate der Behandlung der Polyarthritis rheumatica mit Salicylsaure . Klin Wochenschr 1876;;13:1.
3 +
Schaller J:  Chronic salicylate administration in juvenile rheumatoid arthritis . Pediatrics 1978;;62( (suppl) ):916-925.
4 +
Iancu T, Elian E:  Ultrastructural changes in aspirin hepatotoxicity . Am J Clin Pathol 1976;; 66:570-575.
5 +
Hamdan J, Ahmed M, Sa'adi A:  Salicylate hepatotoxicity in rheumatic fever . Ann Trop Pediatr 1983;;3:89-91.
6 +
 Report of the ad hoc committee to revise Jones' criteria (modified) of the Council on Rheumatic Fever and Congenital Heart Disease of the American Heart Association . Circulation 1965;; 32:664-668.
7 +
Natelson S: Microtechniques of Clinical Chemistry for the Routine Laboratory . Springfield, Ill, Charles C Thomas Publisher, 1957;.
8 +
Saris NE:  Revised IFCC method for aspartate aminotransferase . Clin Chem 1978;;24:720-721.
9 +
Iancu T:  Serum transaminases and salicylate therapy . Br Med J 1972;;2:167.
10 +
Manso C, Taranta A, Nydeck I:  Effect of aspirin administration on serum glutamic oxaloacetic and glutamic pyruvic transaminases in children . Proc Soc Exp Biol Med 1956;;93:84-88.
11 +
Russell AS, Sturge RA, Smith MA:  Serum transaminase during salicylate therapy . Br Med J 1971;;2:428-492.
12 +
Rich R, Johnson J:  Salicylate hepatotoxicity in patients with juvenile rheumatoid arthritis . Arthritis Rheum 1973;;16:1-9.
13 +
Barron KS, Person DA, Brewer EJ:  The toxicity of non-steroidal anti-inflammatory drugs in juvenile rheumatoid arthritis . J Rheumatol 1982;;9:1:149-155.
14 +
Seaman WE, Ishak KG, Plotz PH:  Aspirin-induced hepatotoxicity in patients with systemic lupus erythematosus . Ann Intern Med 1974;;80: 1-8.
15 +
Levy G, Tsuchiya T, Amsel LP:  Limited capacity for salicyl phenolic glucuronide formation and its effect on the kinetics of salicylate elimination in man . Clin Pharmacol Ther 1972;;13: 258-268.
16 +
Tsuchiya T, Levy G:  Biotransformation of salicylic acid to its acyl and phenolic glucuronides in man . J Pharm Sci 1972;;61:800-801.
17 +
Levy G, Yaffe S:  Clinical implications of salicylate-induced liver damage . AJDC 1975;;129: 1385-1386.
18 +
Bell CL, Schur PH:  Juvenile rheumatoid arthritis and salicylate related liver chemistry abnormalities: Clinical and genetic considerations . Arthritis Rheum 1979;;22:592.
19 +
Disciascio G, Taranta A:  Rheumatic fever in children . Am Heart J 1980;;99:635-656.
20 +
Makela A, Yrjana T, Mattila M:  Dosage of salicylates for children with juvenile rheumatoid arthritis . Acta Pediatr Scand 1979;;68:423-430.
21 +
Levinson JE, Baum J, Brewer EJ Jr, et al:  Comparison of toletin sodium and aspirin in the treatment of juvenile rheumatoid arthritis . J Pediatr 1977;;91:799-804.
22 +
Doughty R, Giesecke L, Athreya B:  Salicylate therapy in juvenile rheumatoid arthritis . AJDC 1981;;134:461-466.

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