salicylates and Eosinophilia

Choline magnesium trisalicylate is a non-acetylated salicylate used widely as a nonsteroidal anti-inflammatory drug. Although mild transient hepatotoxicity associated with aspirin and other salicylates has been well documented, most commonly with high-dose treatment for rheumatologic disorders 112), we report a case of severe hypersensitivity hepatitis with striking tissue and peripheral eosinophilia after ingestion of choline magnesium trisalicylate.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Chemical and Drug Induced Liver Injury; Choline; Eosinophilia; Female; Humans; Osteoarthritis; Salicylates

The practical importance of BSR and blood cell changes for the early recognition should not be overestimated. But every symptomless person with raised BSR should be examined very carefully, especially for occult hepatic diseases (active hepatitis, liver cirrhosis), for anaemias, leukaemias, malignant lymphomas and other malignant diseases. The practical use of the diagnosis of blood cell changes is the possible recognition of anaemias, leukaemias and malignant lymphomas.

Topics: Adrenal Cortex Hormones; Anemia; Blood Cell Count; Blood Sedimentation; Eosinophilia; Humans; Hyperlipidemias; Leukemia; Liver Diseases; Lymphoma; Multiple Myeloma; Parasitic Diseases; Salicylates

Of 11 patients with acute rheumatic fever, 9 were treated with a total daily salicylate dosage of 3,6 g or less, 1 patient required a total daily dosage of 5,4 g and another required 9,0 g daily. Six of the 11 patients had elevated serum transaminase levels, and all were asymptomatic. The elevated transaminase levels appear to bear a direct relationship to the serum salicylate level, and a serum salicylate level of 19,2 mg/100 ml appears to be the critical point. In 5 out of the 6 patients with elevated transaminases, the serum salicylate level exceeded 19,2 mg/100 ml, while in the 5 patients with normal transaminases the serum salicylate level did not exceed 19,2 mg/100 ml. Also, in 10 of the 11 patients eosinophilia was noted, but this decreased despite continued or increased salicylate administration. A narrow margin thus appears to exist between therapeutic serum salicylate levels and hepatotoxic levels, and serial serum transaminase estimations are advocated in patients on long-term salicylate therapy.

Topics: Acute Disease; Adolescent; Adult; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Eosinophilia; Female; Humans; Male; Rheumatic Fever; Salicylates

Topics: Alanine Transaminase; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Eosinophilia; Feeding and Eating Disorders; Humans; Nausea; Salicylates; Vomiting