title: An evaluation of the utility of routine laboratory monitoring of juvenile idiopathic arthritis (JIA) patients using non-steroidal anti-inflammatory drugs (NSAIDs): a retrospective review.
abstract: BACKGROUND
  No consensus evidence-based guidelines for the routine laboratory monitoring of children with JIA receiving non-steroidal anti-inflammatory drugs (NSAIDs) exist. The purpose of this study is to evaluate the clinical utility of routine laboratory monitoring of hemoglobin, transaminases, blood urea nitrogen, serum creatinine, and urinalysis in patients with juvenile idiopathic arthritis (JIA) receiving NSAIDs.
  
  
  METHODS
  The medical records of 91 children with JIA followed between 1996 and 2006 were retrospectively reviewed for laboratory results and clinically significant adverse effects attributed to NSAID use. Laboratory abnormalities were documented, with potential adverse clinical sequelae, including if NSAID use was discontinued.
  
  
  RESULTS
  Abnormal laboratory results were recorded for 24 of 91 patients. Nearly all abnormalities were mild and not associated with adverse clinical sequelae. All patients but one continued to receive NSAID therapy after the abnormality was detected.
  
  
  CONCLUSIONS
  Although detection of abnormal laboratory values occurred while on NSAIDs, these abnormalities did not correlate with adverse clinical signs and symptoms. The routine monitoring of laboratory tests in asymptomatic children treated with NSAIDs is of questionable utility.
authors.affiliation: Department of Pediatrics, Division of Rheumatology, Medical College of Wisconsin, Children's Research Institute, Milwaukee, WI, USA. svora@mcw.edu.
authors.forename: Sheetal S
authors.initials: SS
authors.lastname: Vora
authors.forename: Christine E
authors.initials: CE
authors.lastname: Bengtson
authors.forename: Grant D
authors.initials: GD
authors.lastname: Syverson
authors.forename: James J
authors.initials: JJ
authors.lastname: Nocton
references.citation: Am J Dis Child. 1993 Dec;147(12):1280-1
references.pmid: 8249943
references.citation: J Rheumatol. 1995 Jun;22(6):1149-51
references.pmid: 7674245
references.citation: Br J Rheumatol. 1993 Jan;32(1):69-72
references.pmid: 8422564
references.citation: Arthritis Rheum. 1996 Aug;39(8):1385-90
references.pmid: 8702448
references.citation: Arthritis Rheum. 1995 Sep;38(9):1225-31
references.pmid: 7575716
references.citation: Arthritis Rheum. 2002 Feb;46(2):328-46
references.pmid: 11840435
references.citation: Pediatr Dermatol. 2000 Nov-Dec;17(6):480-3
references.pmid: 11123786
references.citation: Am J Dis Child. 1993 Feb;147(2):229-36
references.pmid: 8427252
references.citation: J Pediatr. 1991 Nov;119(5):815-7
references.pmid: 1941392
references.citation: Arthritis Rheum. 1986 Feb;29(2):274-81
references.pmid: 3485433