Correlations between transaminase concentrations and serum salicylate concentration in juvenile rheumatoid arthritis

Miller, John J.; Weissman, David B.

doi:10.1002/art.1780190121

Cited by 33 publications

(10 citation statements)

References 17 publications

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“…There is no rash, but eosinophilia has been described in some cases [56]. Hepatomegaly, hepatic dysfunction, and chronic liver disease generally do not occur [57]. Serum alanine aminotransferase (ALT) levels are elevated [58] and correlate with salicylate levels [57,59].…”

Section: Drug-induced Diseasesmentioning

confidence: 99%

“…Hepatomegaly, hepatic dysfunction, and chronic liver disease generally do not occur [57]. Serum alanine aminotransferase (ALT) levels are elevated [58] and correlate with salicylate levels [57,59]. Elevations in transaminases develop in a dose-related fashion and return to normal within a few days after aspirin is discontinued or the dose is reduced [55].…”

Section: Drug-induced Diseasesmentioning

confidence: 99%

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Gastrointestinal and Hepatic Manifestations of Rheumatoid Arthritis

Ebert

Hagspiel

2011

Dig Dis Sci

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Rheumatoid arthritis (RA), characterized by inflammation of the synovium and surrounding structures, has a prevalence of 0.5-1%. Rheumatoid vasculitis (RV) is an inflammatory condition of the small- and medium-sized vessels that affects up to 5% of patients with RA with intestinal involvement in 10-38% of these cases. Clinically apparent RV of the gastrointestinal (GI) tract, while rare, is often catastrophic, resulting in ischemic ulcers and bowel infarction. Vasculitis of the colon may present as pancolitis clinically similar to ulcerative colitis. Rectal biopsies that include submucosal vessels are positive for vasculitis in up to 40% of cases. Abnormal esophageal motility in RA may result in heartburn and dysphagia. Chronic atrophic gastritis may be associated with hypergastrinemia and hypo- or achlorhydria, promoting small bowel bacterial overgrowth. RA is the most common cause of secondary amyloidosis with GI symptoms in 22% of affected patients. Although amyloid is usually found in the liver, it is rarely evident clinically. Felty's syndrome occurs in less than 1% of patients with RA and is characterized by neutropenia and splenomegaly. The liver may be involved with portal fibrosis or nodular regenerative hyperplasia. Liver histology is abnormal in 92% of RA patients at autopsy, although the changes are usually mild without associated hepatomegaly. Drug-induced liver disease may occur with aspirin, sulfasalazine, and methotrexate. Significant liver damage is rare if the drug is discontinued or the patient is properly monitored. RA can affect both the GI tract and the liver; changes are usually mild except with RV.

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Section: Drug-induced Diseasesmentioning

confidence: 99%

Section: Drug-induced Diseasesmentioning

confidence: 99%

Gastrointestinal and Hepatic Manifestations of Rheumatoid Arthritis

Ebert

Hagspiel

2011

Dig Dis Sci

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“…Other complications of aspirin therapy include elevation of hepatic enzymes [14] and prolongation of the bleeding time through the effect on platelet function. Patients with nasal polyps and asthma may have a hypersensitivity reaction if given aspirin, while those with glucose-6-phosphate dehy-drogenase and pyruvate kinase deficiency can experience haemolysis.…”

Section: Aspirin (Acetylsalicylic Acid)mentioning

confidence: 99%

Juvenile Arthritis

Siegel

1996

Clin. Immunother.

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“…Elevations of serum transaminases have been reported in 20 to 60%of patients receiving high doses ofaspirin for rheumatic fever, rheumatoid arthritis (Russel et al 1971) and systemic lupus erythematosus (Seaman & Plotz 1976), the latter group being particularly susceptible. This form of hepatotoxicity is dose related and abnormalities in liver function tests have been correlated with plasma salicylate concentrations (Miller & Weissman 1976), and does not occur with less than 2 gfday. Although salicylate hepatotoxicity usually occurs with plasma concentrations greater than 250 gfL (Miller & Weissman 1976), it has been observed at concentrations of 90 gfL (O'Gormann & Koff 1977).…”

Section: Salicylatesmentioning

confidence: 99%

“…This form of hepatotoxicity is dose related and abnormalities in liver function tests have been correlated with plasma salicylate concentrations (Miller & Weissman 1976), and does not occur with less than 2 gfday. Although salicylate hepatotoxicity usually occurs with plasma concentrations greater than 250 gfL (Miller & Weissman 1976), it has been observed at concentrations of 90 gfL (O'Gormann & Koff 1977). Histological studies show focal necrosis and portal tract infiltration.…”

Section: Salicylatesmentioning

confidence: 99%

Aspirin, Paracetamol and Non-Steroidal Anti-Inflammatory Drugs

Fowler¹

1987

Medical Toxicology

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Non-steroidal anti-inflammatory drugs (NSAIDs) effectively control the symptoms of many of the rheumatic diseases although they have little effect on the underlying causes. Their effect is mainly on the mediators of the inflammatory process. Unfortunately, these mediators have important physiological roles in the maintenance of health, particularly in the gastrointestinal tract and the kidney, so that their inhibition results in many unwanted reactions of varying severity. The mechanisms underlying these reactions are described. Their occurrence varies, both qualitatively and quantitatively, and an attempt is made to assess these differences, although it may be that they are related directly to differences in dosage and therapeutic efficacy. In addition, immunologically mediated adverse reactions occur. These mechanisms are outlined and related to the clinical picture. There are considerable differences in frequency of reactions between the compounds: in particular there is a wide variation in the rate of dermatological reactions of this type. Agranulocytosis has been particularly associated with the pyrazolone compounds, although it has been reported with most others. Aplastic anaemia, which may not be an immune-mediated reaction, is also thought of as a pyrazolone reaction, but the incidence with indomethacin approaches a similar level. Although all drugs analysed may cause hepatic reactions, these are rare except with the now withdrawn benoxaprofen. Several types of immunologically mediated renal reactions occur and these rarities are also described. Paracetamol does not have any effect on the inflammatory mediators. Anxieties about this substance relates to the parent compound phenacetin and its necrotic effect on the renal papillae. There is extensive literature on this subject concerning not only paracetamol, but also aspirin and other NSAIDs. This is also assessed and summarised. The danger of paracetamol as a direct hepatic toxin in self-poisoning is discussed. Novel NSAIDs are introduced and others withdrawn with frequent and monotonous regularity. Sometimes the reasons have some medical or scientific plausibility, but often they are over-reactions by registration authorities or pharmaceutical companies in response to uninformed media publicity. The problems of the numerically and scientifically accurate collection and assessment of adverse reaction data are legion and as a result useful agents have been lost. Some of these difficulties are described, and some non-drug 'adverse reactions' are described.(ABSTRACT TRUNCATED AT 400 WORDS)

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Correlations between transaminase concentrations and serum salicylate concentration in juvenile rheumatoid arthritis

Cited by 33 publications

References 17 publications

Gastrointestinal and Hepatic Manifestations of Rheumatoid Arthritis

Gastrointestinal and Hepatic Manifestations of Rheumatoid Arthritis

Juvenile Arthritis

Aspirin, Paracetamol and Non-Steroidal Anti-Inflammatory Drugs

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