Dipyrone, a Pyrasolone derivative, belongs to the non-steroidal anti-inflammatory class of drags.It has been in use as analgesis and antipiretic agent for about 100 years, and is also known for its spasmolytic effect. The drag was withdrawn from the US market in 1979 because of its potentially fatal adverse effect - agranulocytosis. However, in many other countries it is a popular drag, used by children and adults as over-the-counter preparation. Information about renal failure following Dipyrone treatment is scarce. The purpouse of our report is to describe four previously health children who developed acute renal failure following the ingestion of a self-prescribed Dipyrone. These children, ages 7 - 16 y, took 20 - 125 mg/kg/day of the drag for analgesis purpose. A few days after ingesting the Dipyrone they were diagnosed as suffering from acute renal failure as detect by blood tests. Their creatinin levels were 0,8-2,3 mg/dl and their urea levels were 26-59 mg/dl. The maximum creatinin level was 4 mg/dl. The maximum urine protein was 1,5 g/d. Renal sonogram was performed in all of the cases and showed hyperechogenic kidneys. In one of the cases, a renal biopsy was taken, and the specimen revealed pathology of acute interstitial nephritis. All the children were cured spontaneously or after steroid treatment.
Is is possible that the renal effect is dose-depended, due to haemodinamic effects related to inhybition of prostoglandin synthesis. Another possible mechanism is drag-hypersensitivity which causes acute interstitial nephritis.
It is important that the population in general and doctors in specific will be aware of this possible adverse effect and will take this into account when concidering using Dipyrone.
06.03.2007, 12:14
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