title: Experience with misoprostol therapy for NSAID gastropathy in children.
abstract: OBJECTIVE
  To determine the effect of misoprostol, a synthetic prostaglandin E1 analogue, on the gastrointestinal tract (GIT) symptoms associated with non-steroidal anti-inflammatory drug (NSAID) administration and on the haemoglobin value, in children.
  
  
  METHODS
  Retrospective chart review of children attending the paediatric rheumatology clinic at a tertiary referral hospital over a three year period, who were receiving NSAIDs and were prescribed misoprostol for treatment of GIT symptoms or anaemia.
  
  
  RESULTS
  Twenty five children (mean age 12.0 (SD 2.8) (range 7-17) years were prescribed misoprostol (mean dose 308.4 (76.5) micrograms/m2/day; 9.8 (2.5) micrograms/kg/day) while NSAID therapy was continued. Of the 22 (88%) patients with GIT complaints, 18 (82%) had complete resolution of symptoms and two (9%) had some improvement. Four patients (18%) had a recurrence of symptoms after initial resolution while still receiving misoprostol. Misoprostol therapy was associated with a statistically significant increase in haemoglobin concentration (mean value before misoprostol 115 (18) g/l; after misoprostol 126 (15) g/l (p = 0.02)). The only adverse effect reported was self limited diarrhoea in one child.
  
  
  CONCLUSIONS
  Misoprostol appeared to be effective in the treatment of GIT symptoms in children receiving NSAIDs and to result in significant increase in the haemoglobin concentration. Further prospective studies are needed to evaluate the role of misoprostol therapy for NSAID associated GIT complaints in the paediatric population.
authors.affiliation: Hospital for Sick Children, Department of Pediatrics, University of Toronto, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Gazarian
authors.forename: M
authors.initials: M
authors.lastname: Berkovitch
authors.forename: G
authors.initials: G
authors.lastname: Koren
authors.forename: E D
authors.initials: ED
authors.lastname: Silverman
authors.forename: R M
authors.initials: RM
authors.lastname: Laxer
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced / Q000188:drug therapy; D000293:Adolescent; D000740:Anemia / Q000188:drug therapy; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy; D002648:Child; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000188:drug therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D006454:Hemoglobins; D016595:Misoprostol