Mărginean Maria Oana, Meliț Lorena Elena, Mocanu Simona, Săsăran Vlăduț
Paediatrics Clinic 1, Târgu Mureș, Romania.
University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Romania.
J Crit Care Med (Targu Mures). 2018 Oct 1;4(4):143-146. doi: 10.2478/jccm-2018-0022. eCollection 2018 Oct.
Upper gastrointestinal bleeding is an uncommon but possible life-threatening entity in children, frequently caused by erosive gastritis. Non-steroidal anti-inflammatory drugs are one of the most common class of drugs which can cause gastrointestinal complications, including hemorrhagic gastritis.
The case of a 6-year-old male, admitted for hematemesis, abdominal pain and loss of appetite. It was ascertained at the time of admission, that ibuprofen had been prescribed as the patient had a fever. This was inappropriately administered as the mother did not respect the intervals between the doses.Initial laboratory tests revealed neutrophilia, leukopenia, high levels of lactate dehydrogenase and urea. An upper digestive endoscopy revealed an increased friability of the mucosa, digested blood in the gastric corpus and fornix. No active bleeding site was detected. The histopathological examination described a reactive modification of the corporeal gastric mucosa. Intravenous treatment with proton pump inhibitors and fluid replacement were initiated, with favorable results.
Ibuprofen can lead to upper digestive hemorrhage independently of the administered dose. Parents should avoid administering Ibuprofen for fever suppression without consulting their pediatrician.
上消化道出血在儿童中虽不常见,但可能危及生命,常由糜烂性胃炎引起。非甾体抗炎药是最常见的可导致胃肠道并发症(包括出血性胃炎)的一类药物。
一名6岁男性因呕血、腹痛和食欲不振入院。入院时确定,因患者发烧曾开具布洛芬。由于母亲未遵守给药间隔,用药不当。初始实验室检查显示中性粒细胞增多、白细胞减少、乳酸脱氢酶和尿素水平升高。上消化道内镜检查显示黏膜脆性增加,胃体和胃穹窿有消化性血液。未检测到活动性出血部位。组织病理学检查描述为胃体黏膜的反应性改变。开始静脉注射质子泵抑制剂和补液治疗,效果良好。
布洛芬可独立于给药剂量导致上消化道出血。家长在未咨询儿科医生的情况下,应避免自行给孩子服用布洛芬来退烧。