Abstract
Although gastrointestinal hemorrhage (due to gastritis) associated with the abuse of ASA-containing preparations by adults is well recognized, its importance as a cause of severe GIH in children has not been well appreciated, either in the literature or practice of pediatrics. From 1965–1970 we observed 12 children from 3 months to 14 years of age in whom severe hematemesis and/or melena followed ordinary (antipyretic) doses of ASA. Hemoglobin concentrations were decreased in all, with levels below 7 gm% in 3 patients; RBC morphology and reticulocytosis suggested acute blood loss. Studies of hemostasis (prothrombin time, partial thromboplastin time, platelet count, and Ivy Bleeding time) were normal. Gastrointestinal roentgenograms revealed no lesions. Laparotomy in one patient yielded negative results. A history of ASA ingestion had been recorded initially in several patients, but the possibility of an etiologic relationship between ASA and GIH was not considered until the above studies had been reported as normal. Discontinuation of ASA, observation of serial Hb levels and iron prophylaxis has sufficed in the management of this self-limited iatrogenic problem. Our experience with these cases suggests the need to re-evaluate current pharmacologic practices regarding ASA therapy in children.
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Naiman, J., Bergman, G. & Philippidis, P. Severe gastrointestinal hemorrhage (GIH) after “therapeutic” doses of aspirin (ASA) in normal chieldren. Pediatr Res 5, 390 (1971). https://doi.org/10.1203/00006450-197108000-00080
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DOI: https://doi.org/10.1203/00006450-197108000-00080