title: Acute hemorrhagic, hepatic, and neurologic manifestations in juvenile rheumatoid arthritis: possible relationship to drugs or infection.
abstract: Seven children with juvenile rheumatoid arthritis had a syndrome characterized by hemorrhage and neurologic, hepatic, hematologic, and metabolic manifestations. The disease did not seem to conform clearly to the characteristics of Reye syndrome or any other well-known entity. This severe complication may be induced by macrophage activation secondary to a drug or intercurrent infection. Our data suggest that a sudden fall in erythrocyte sedimentation rate or in platelet and fibrinogen levels may mark the start of this complication and may be an indication for rapid steroid therapy.
mesh_terms: D000208:Acute Disease; D001171:Arthritis, Juvenile / Q000188:drug therapy / Q000503:physiopathology*; D001241:Aspirin / Q000009:adverse effects; D001424:Bacterial Infections / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006046:Gold / Q000009:adverse effects; D006470:Hemorrhage / Q000209:etiology* / Q000503:physiopathology; D006529:Hepatomegaly / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D012202:Reye Syndrome / Q000175:diagnosis; D013577:Syndrome
chemical_list: D006046:Gold; D001241:Aspirin