salicylates and Lung-Diseases

Drug-induced lung disease presents several diagnostic and therapeutic problems to the clinician. This is especially true in the case of lung disease associated with antirheumatic agents in which pulmonary disease may be due to the underlying disorder. Unfortunately, no specific markers exist to differentiate drug-induced lung disease from other pathologic processes. In addition, the numerous drugs often used simultaneously or in close sequence in rheumatic disorders make assignment of toxicity to a specific agent difficult. Six groups of drugs used as anti-inflammatory/antirheumatic agents have been discussed in association with pulmonary damage penicillamine, gold, methotrexate, salicylates, NSAIDs, and colchicine. The major clinical syndromes ascribed to these drugs include hypersensitivity pneumonitis and chronic alveolitis/fibrosis (penicillamine, gold, methotrexate, NSAIDs), pulmonary-renal syndrome (penicillamine), bronchiolitis obliterans (penicillamine, gold), and noncardiogenic pulmonary edema (salicylates, colchicine). Unfortunately, treatment options remain limited. Withdrawal of the offending drug and supportive care are the mainstays of therapy. In cases in which active inflammation causes significant derangement of gas exchange, corticosteroids are warranted. More aggressive management using immunosuppressive drugs has been recommended in cases of refractory PABO and PAGS, but these recommendations are at present based only on isolated case reports.

Topics: Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Antirheumatic Agents; Humans; Lung Diseases; Methotrexate; Organogold Compounds; Penicillamine; Salicylates

Topics: Anti-Inflammatory Agents; Arthritis, Juvenile; Arthritis, Rheumatoid; Azathioprine; Chloroquine; Cyclophosphamide; Drug Therapy, Combination; Felty Syndrome; Gold; Humans; Hydroxychloroquine; Immunosuppressive Agents; Leukapheresis; Lung Diseases; Lymphoid Tissue; Methotrexate; Penicillamine; Plasmapheresis; Radiotherapy; Rheumatic Diseases; Salicylates; Sjogren's Syndrome; Spinal Diseases; Vasculitis

Topics: Aminobutyrates; Aminophylline; Carbonic Anhydrase Inhibitors; Central Nervous System Stimulants; Drug Therapy; Flavones; Humans; Lung Diseases; Lung Diseases, Obstructive; Nikethamide; Respiratory Insufficiency; Respiratory System Agents; Salicylates; Thiazoles; Toxicology; Tromethamine

Metabolic acidosis is associated with most severe malaria deaths in African children, and most deaths occur before maximum antimalarial action is achieved. Thus, specific acidosis treatment may reduce mortality. However, the underlying mechanisms remain poorly understood and no specific interventions have been developed. A detailed characterisation of this acidosis is critical in treatment development. We used the traditional and Stewart's approach to characterise acidosis in consecutive paediatric admissions for malaria and other acute non-surgical conditions to Kilifi District Hospital in Kenya. The overall acidosis prevalence was 21%. Gastroenteritis had the highest prevalence (61%). Both the mean albumin-corrected anion gap and the strong ion gap were high (>13 mmol/l and >0 mmol/l, respectively) in malaria, gastroenteritis, lower respiratory tract infection and malnutrition. Presence of salicylate in plasma was not associated with acidosis but was associated with signs of severe illness (odds ratio 2.11, 95% CI 1.1-4.2). In malaria, mean (95% CI) strong ion gap was 15 (14-7) mmol/l, and lactate, creatinine and inorganic phosphorous explained only approximately 40% of the variability in base excess (adjusted R2 = 0.397). Acidosis may be more common than previously recognised amongst paediatric admissions in Africa and is characterised by the presence of currently unidentified strong anions. In malaria, lactate and ketones, but not salicylate, are associated with acidosis. However, unidentified anions may be more important.

Topics: 3-Hydroxybutyric Acid; Acidosis; Acute Disease; Biomarkers; Child, Preschool; Creatinine; Female; Gastroenteritis; Hospitalization; Humans; Infant; Kenya; Ketones; Lactates; Lung Diseases; Malaria; Male; Malnutrition; Regression Analysis; Salicylates

The basic phospholipase A(2) (VRV-PL-VIIIa) from Vipera russelli venom induces multiple toxic effects including neurotoxicity, myotoxicity, edema and hemorrhage. This phospholipase A(2) has been extensively characterized for its pharmacological properties except for hemorrhagic activity. In the present investigation, the lung hemorrhagic activity was assayed using lung dye diffusion method. The investigations to understand the mechanism of lung hemorrhage induction by VRV-PL-VIIIa was followed by chemical modification studies and also by interaction with an antihemorrhagic factor p-anisic acid (4-methoxy benzoic acid). In presence of 1:2 mol:mol PLA(2): anisic acid, the lung hemorrhagic and edema inducing activities were completely neutralized in experimental animals; however, catalytic and anticoagulant activities were not neutralized. Carbamylation of VRV-PL-VIIIa resulted in the loss of lung hemorrhage and edema inducing activities. In contrast, carbamylation of VRV-PL-VIIIa in the presence of anisic acid could not neutralize the lung hemorrhage and edema inducing activities. The anticoagulant and enzyme activities were only partially neutralized when carbamylated both in the presence and absence of anisic acid.

Topics: Animals; Anticoagulants; Betaine; Carbamyl Phosphate; Daboia; Edema; Group II Phospholipases A2; Hemolysis; Hemorrhage; Hydroxybenzoate Ethers; Lung Diseases; Male; Mice; Phospholipases A; Proteins; Prothrombin Time; Rats; Salicylates; Spectrometry, Fluorescence; Viper Venoms

The anticoagulant property of aspirin has long been appreciated. Recently, the physiologic mechanism has been identified and documented extensively. Despite the long-lasting inhibition of platelet function and clinically significant postoperative hemorrhage following aspirin use, few serious complications or fatalities are reported in the current literature. We report a case in which fatal hemorrhage resulted from minor trauma following massive salicylate ingestion. A review of the cyclo-oxygenase mechanism is presented.

Topics: Alcoholism; Aspirin; Death, Sudden; Hemorrhage; Humans; Lung Diseases; Male; Mediastinal Diseases; Middle Aged; Purpura; Salicylates; Thrombocytopenia; Wounds, Nonpenetrating

Topics: Adenosine Diphosphate; Animals; Female; Fibrinolytic Agents; Injections, Intravenous; Lung Diseases; Male; Rats; Rats, Inbred Strains; Salicylates; Thrombosis

Topics: Animals; Arachidonic Acids; Cricetinae; Disease Models, Animal; Fibrinolytic Agents; Injections, Intravenous; Lung Diseases; Mice; Rabbits; Respiration Disorders; Salicylates; Thrombosis

A boy, 2 years old, developed a HUS after a pneumonitis. He was treated with Heparin, salicylates and recurrent peritoneal dialysis and recovered slowly. The course of the disease was complicated by myocarditis, gastric hemorrhage and severe neurologic disturbances. 7 days after unset of hemolysis a cold agglutinin titer of 1:256 was detected. This fact arises the question whether infection with Mycoplasma pneumoniae and the presence of cold agglutinins in serum could be involved in the development of HUS. The possibility of a viral etiology for this disease is discussed.

Topics: Agglutinins; Child, Preschool; Cold Temperature; Gastrointestinal Hemorrhage; Hemolysis; Hemolytic-Uremic Syndrome; Heparin; Humans; Lung Diseases; Male; Mycoplasma Infections; Myocarditis; Nervous System Diseases; Peritoneal Dialysis; Salicylates

Topics: Adrenal Cortex Hormones; Animals; Haplorhini; Hemodynamics; Lung; Lung Diseases; Methylprednisolone; Pulmonary Circulation; Respiratory Function Tests; Salicylates; Shock; Shock, Hemorrhagic; Shock, Septic

Topics: Aminosalicylic Acids; Animals; Chickens; Guinea Pigs; Humans; Lung Diseases; Mice; Mycobacterium; Pigments, Biological; Rabbits; Salicylates; Soil Microbiology; Sputum; Virulence

Topics: Alcohols; Amides; Amidohydrolases; Amines; Aminosalicylic Acids; Bacteriological Techniques; Culture Media; Fructose; Glucosamine; Glycols; Humans; Lung Diseases; Malates; Mycobacterium; Niacinamide; Nitrates; Nitrites; Picrates; Pyrazinamide; Salicylates; Succinates; Sulfatases

Topics: Antidepressive Agents; Barbiturates; Blood Circulation; Carbamates; Carbon Monoxide Poisoning; France; Humans; Hypoxia; Lung Diseases; Morphinans; Phenothiazines; Poisoning; Respiration; Salicylates; Seizures; Trichloroethylene; Vascular Diseases

Topics: Anthracosilicosis; Hemorrhage; Humans; Kidney Diseases; Lung Diseases; Muscular Diseases; Penicillins; Radiography, Thoracic; Salicylates; Scleroderma, Systemic; Vitamin E

Topics: Arthritis; Arthritis, Rheumatoid; Blood Transfusion; Collagen Diseases; Connective Tissue; Cortisone; Humans; Lung Diseases; Lupus Erythematosus, Systemic; Pathology; Physical Therapy Modalities; Polyarteritis Nodosa; Radiography, Thoracic; Salicylates; Scleroderma, Systemic

Topics: Humans; Lung Diseases; Myocarditis; Pulmonary Edema; Rheumatic Heart Disease; Salicylates; Sodium Salicylate

Topics: Edema; Lung Diseases; Pulmonary Edema; Rheumatic Fever; Salicylates

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Humans; Infant; Lung Diseases; Salicylates

Topics: Aminosalicylic Acid; Hemochromatosis; Hemosiderosis; Hemosiderosis, Pulmonary; Lung Diseases; Salicylates