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Article
January 1986

Renal Papillary Necrosis in Children With Chronic Arthritis

Author Affiliations

From the Department of Pediatrics, University of British Columbia, Vancouver, and British Columbia's Children's Hospital, Vancouver.

Am J Dis Child. 1986;140(1):20-22. doi:10.1001/archpedi.1986.02140150022023
Abstract

• Five ambulatory children with various types of chronic arthritis developed renal papillary necrosis (RPN), as documented by intravenous pyelography. Each child was being treated with nonsteroidal anti-inflammatory drugs (NSAIDs) at the time of diagnosis of RPN and had had episodes of gross or microscopic hematuria for several months prior to diagnosis. In each child hematuria was associated with more than one NSAID, and three of the five children also had ingested acetaminophen intermittently. Glomerular function has remained normal and hypertension has not developed, but management of these children has necessitated reduction or elimination of NSAIDs. As evidenced by these five cases, microscopic or gross hematuria in a child with chronic arthritis treated with anti-inflammatory drugs should raise the possibility of RPN.

(AJDC 1986;140:20-22)

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