Increased incidence of epistaxis in adolescents with familial hypercholesterolemia treated with fish oil

Modulating the Progression in IgA Nephropathy

“…In addition, the adult patients complained of excessive belching and the onerous fishy taste of the medicine [72], which may decrease compliance especially in children. In addition, children treated with fish oil for other conditions encounter an increased incidence of epistaxis [73]. A recent study performed by the Southwest Pediatric Nephrology Study group failed to demonstrate therapeutic efficacy of fish oil supplementation in children and young adults with IgA nephropathy [74].…”

Opinion of the Scientific Panel on contaminants in the food chain [CONTAM] related to the safety assessment of wild and farmed fish

“…Adolescents with familial hypercholesterolaemia who were treated with 1.5 g of LC n-3 PUFA from fish oil showed a high prevalence of epistaxis after several months of treatment (Clarke et al, 1990). Clinical bleeding occurred in the same frequency in the treatment and placebo arms of randomised controlled trials with LC n-3 PUFA and was often associated with concomitant anticoagulative medication (Wang et al, 2004).…”

Essential fatty acids as determinants of lipid requirements in infants, children and adults

“…These effects seem to be dose dependent but to date no major clinically signi®cant bleeding has been demonstrated in relation to the ingestion of ®sh oils (Lox, 1990), although one study showed increased incidence of epistaxis when high dose ®sh oil was administered to hypercholesterolemic adolescents (Clarke et al, 1990). Platelet counts may be affected by large doses of marine oil and platelet half-life may be shortened.…”

“…Clinical studies have demonstrated increased epistaxis in adolescents given high doses of ®sh oil. On the other hand there is evidence for small non-signi®cant changes in bleeding time in infants given a marine oil supplemented formula (Clarke et al, 1990;Uauy et al, 1994). The use of marine oils has some potential toxicological risks that can be circumvented by careful processing, storing and preservation of the unsaturated fatty acids.…”