Fulminant hepatic failure and paracetamol overuse with therapeutic intent in febrile children

Ranganathan, S.; Sathiadas, M. G.; Sumanasena, Samanmali P; Fernandopulle, M; Lamabadusuriya, SP; Fernandopulle, B. M. R.

doi:10.1007/bf02859276

Cited by 22 publications

(18 citation statements)

References 11 publications

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“…We did not observe worse liver damage among patients who used acetaminophen compared with those who did not, maybe because this is associated with high doses of this medication 39 , which was not reported by our patients.…”

Section: Discussioncontrasting

confidence: 62%

Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

Tristão-Sá

Kubelka

Zandonade

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction:To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. Methods: A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV) seropositive and pregnant women were excluded from the study. Results: At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90) of dengue patients. We also observed that, 57.7% (15/26) of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV) infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT) levels overcame aspartate aminotransferase (AST) during the convalescent period. Male patients were more severely affected than females. Conclusions: Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.

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Section: Discussioncontrasting

confidence: 62%

Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

Tristão-Sá

Kubelka

Zandonade

et al. 2012

Rev. Soc. Bras. Med. Trop.

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“…7 However, it has been poorly investigated and is mostly attributed to multiple supra-therapeutic doses. 13,14 Apart from self-treatment, the most common prescription which produced doses >60 mg/kg/day in the study population was 4 g of paracetamol per day. We suggest that 3 g per day should be the maximum dosage given to adult patients during dengue epidemics.…”

Section: Discussionmentioning

confidence: 99%

Predictors of severe manifestations in a cohort of adult dengue patients

Thomas

Brouste

Najioullah

et al. 2010

Journal of Clinical Virology

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“…Lack of access to drug information resources,43 passive attitude of physicians towards drug information centres,44 underutilisation of drug information centres,44 overuse of medicines with therapeutic intent,45 inadequate labelling of drugs24 and parental mistaken beliefs and undesirable attitudes towards medication use,25 all possibly leading to medication errors in children…”

Section: Lack Of Access To Paediatric Medicinesmentioning

confidence: 99%

Realities of paediatric pharmacotherapy in the developing world

Hoppu

Ranganathan

Dodoo

2011

Archives of Disease in Childhood

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Diseases causing high mortality in children under 5 years of age in resource limited settings (RLS) could be treated if children in these countries had access to existing medicines. It took 30 years before the WHO Essential Medicines List (EML) considered the issue of medicines for children, with the first EML for children being published in 2007. Recent data indicate that less than half of the key paediatric essential medicines are available in countries of sub-Saharan Africa. Problems include substandard medicines, irrational use of medicines, inefficiency and even possible corruption in pharmaceutical management systems. These are global issues which affect RLS most. Clinical trials in developing countries for the benefit of children are needed but challenging in several ways. In this review, the authors will consider the following areas where progress could improve paediatric pharmacotherapy in RLS: registration and regulation of medicines, rational use of medicines, clinical trials in children and restriction of corruption in pharmaceutical management systems.

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Fulminant hepatic failure and paracetamol overuse with therapeutic intent in febrile children

Abstract: Exposure to multiple supratherapeutic doses of paracetamol is a risk factor to develop fulminant hepatic failure in children with an acute viral like febrile illness.

Cited by 22 publications

References 11 publications

Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

Predictors of severe manifestations in a cohort of adult dengue patients

Realities of paediatric pharmacotherapy in the developing world

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