Serious upper gastrointestinal complications of NSAIDs and COX-2 selective agents

Dengue, bleeding and non-steroidal anti-inflammatory drugs

“…Furthermore, platelet function is abnormal in dengue infections with impaired platelet aggregation and markedly shortened platelet survival. In a study of 170 children with Dengue Shock Syndrome abnormalities were seen in all the major pathways of the coagulation cascade (i.e., low levels of the natural anticoagulant proteins and increased levels of the major procoagulant and anti-brinolytic agents), even though serious bleeding manifestations were relatively infrequent 32 . In this context, it is clear that NSAID can lead to increased bleeding in patients with dengue.…”

“…They exhibit a broad spectrum of liver damage ranging from asymptomatic, transient, hypertransaminasemia to fulminant hepatic failure 30 . However, the risk of developing acute liver injury is very low in epidemiological studies though diclofenac is known to have an excess risk [31][32][33] . Though hepatotoxicity usually occurs 12 weeks after initiation of therapy, it can occur at any time after drug administration 30 .…”