ABSTRACT
Analgesic abuse is common in Thailand. Heavy use of analgesic may also increase risk of chronic nephropathy. However, the extent of this risk remains unclear. We carried out a case-control study in three referral hospitals. A total of 84 patients with newly diagnosed of chronic tubulointerstitial nephritis were enrolled as cases. Two control groups were randomly selected, 192 from hospitalized patients who had no renal disease and serum creatinine below 1.2 mg/dl and 166 from relatives of friends visiting the hospitals. Both cases and controls were interviewed by a standardized pre-coded questionnaire to obtain histories of analgesic use before diagnosis of renal disease. On multiple logistic regression analysis, patients whose estimated lifetime use of acetaminophen of 1,000 g or more had an increased risk of chronic nephropathy compared with non-users, the odds ratio (OR) was 5.9 (95% confidence interval (CI) 1.3-25.6, hospital controls) and OR = 5.8 (95% CI 1.04-31.9, visitor controls). Also, uses of aspirin showed a similar relationship. Patients who used aspirin 1,000 g or more per lifetime had higher risk of chronic nephropathy when compared to non-users, the odds ratio were 7.1 (95% CI 2.0-25.8, hospital controls) and 20.4 (95% CI 2.4-174.2) for visitor controls. These data indicate that analgesic abuse increased risk of chronic nephropathy in Thailand.
Subject(s)
Acetaminophen , Adult , Analgesics, Non-Narcotic , Anti-Inflammatory Agents, Non-Steroidal , Aspirin , Case-Control Studies , Chronic Disease , Female , Humans , Logistic Models , Male , Middle Aged , Nephritis, Interstitial/chemically induced , Odds Ratio , Surveys and Questionnaires , Risk Factors , Substance-Related Disorders/complications , ThailandABSTRACT
A case of full blown systemic lupus erythematosus (SLE) was treated with steroid. The patient was in remission with low dose of prednisolone for a year. When she became pregnant, there was no relapse of SLE activities in any organ. However, she developed gum bleeding and petechiae due to thrombocytopenia in the second half of the pregnancy. With a normal amount of megakaryocyte in the bone marrow, it was supposed to be due to SLE which no longer responded to even a full dose of steroid. Therefore, danazol 600 mg/day was given orally and she made a complete recovery within one week. She delivered vaginally a normal female newborn without fetal thrombocytopenia or bleeding.