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Renal Papillary Necrosis in Children With Chronic Arthritis

MICHAEL D. BAILIE, MD, PHD
Am J Dis Child. 1986;140(1):16-17. doi:10.1001/archpedi.1986.02140150018020.
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With the increasing number and use of nonsteroidal anti-inflammatory drugs (NSAIDs) available over the counter or by prescription, both the physician and the consumer must become more familiar with the potential side effects. The NSAIDs have at least one common action: they inhibit the formation of prostaglandins (PGs). Many of the therapeutic effects, as well as the potential side effects, of these drugs are related to this action.

"Prostanoids" are compounds that include the PGs and thromboxane. They are formed from the 20-carbon essential fatty acid, arachidonic acid, in many organs and tissues, including the kidney. The biochemistry and pharmacology of the renal PGs have recently been reviewed in detail.1

The PGs are formed by a series of enzymatic reactions, the first being the release of arachidonic acid from phospholipid by phospholipase A. Arachidonic acid is converted by cyclooxygenase to the intermediate PGs, ie, PGG

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