Document Detail


In utero exposure to nonsteroidal anti-inflammatory drugs: neonatal renal failure.
MedLine Citation:
PMID:  14648334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a case of neonatal transient renal failure after maternal ingestion of diclofenac, paracetamol, and nimesulide during pregnancy. The baby girl was delivered at the 33 weeks gestation for complete absence of amniotic fluid. Acute renal failure was present. Urine output started 12 h after birth, increasing to polyuria on day 6, and then decreasing gradually to normal values. Serum creatinine normalized on day 6. Several cases of severe and sometimes irreversible renal problems have been described in neonates exposed to indomethacin, a non-selective cyclooxgenase (COX) inhibitor, during their fetal life. More recently, the use of nimesulide, a selective COX-2 inhibitor, as a tocolytic agent has been advocated. Although it is difficult to ascribe the observed side effects to one specific drug in our patient, using the Naranjo ADR probability scale, renal failure was probably related to nimesulide exposure. Paracetamol is considered safe at therapeutic doses, and there are no reports of prenatal diclofenac toxicity. However, recently there have been some reports of neonatal renal failure associated with maternal nimesulide consumption and probably modulated by genetic factors. Hence, cautious use of nimesulide during pregnancy must be advocated.
Authors:
Daniela Benini; Vassilios Fanos; Laura Cuzzolin; Luciano Tatò
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2003-11-25
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  19     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-01-14     Completed Date:  2004-09-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  232-4     Citation Subset:  IM    
Affiliation:
Pediatric Division, Negrar Hospital, Verona, Italy.
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / adverse effects,  therapeutic use
Adult
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*,  therapeutic use
Diclofenac / adverse effects,  therapeutic use
Female
Humans
Infant, Newborn
Kidney Failure, Acute / chemically induced*
Lumbosacral Plexus
Neuritis / drug therapy
Pregnancy
Prenatal Exposure Delayed Effects*
Sciatic Nerve
Sulfonamides / adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Sulfonamides; 103-90-2/Acetaminophen; 15307-86-5/Diclofenac; 51803-78-2/nimesulide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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