Symptomatic salicylate ototoxicity: a useful indicator of serum salicylate concentration?

Article Abstract:

Major side effects of salicylate drugs such as aspirin are tinnitus (ringing in the ears) and noticeable hearing loss. Development of these problems is thought to be related to higher salicylate dosage and increased blood levels of the drugs. The salicylate doses that produce therapeutic effects for the relief of joint pain or other disorders without causing toxicity vary greatly, so that repeated monitoring is needed. Toxic effects on the ears have been used as indicators of blood salicylate levels, but seem to be nonspecific and unreliable. Tinnitus and hearing loss were evaluated in 260 control patients with osteoarthritis who were not taking salicylates, 112 control patients with rheumatoid arthritis who had not taken salicylates for 1.5 years, 56 arthritic patients taking salicylates who reported tinnitus, and 94 arthritic patients taking salicylates who had high blood salicylate levels. Tinnitus or hearing loss was reported by up to 26 percent of the control patients. In patients who were taking salicylates these problems were not consistently related to high blood salicylate levels. This means that ototoxicity (toxicity involving the ear) was not consistently and solely related to high salicylate levels in the blood, and was thus a nonspecific test for monitoring these levels. Incidentally, ototoxicity in patients taking low salicylate doses usually worsened at higher doses. Over half the patients with high blood salicylate levels had no hearing problems, so that ototoxicity was insensitive as an indicator of high salicylate blood levels in this group. The findings indicate that health practitioners should not rely on ototoxicity as an indicator of the level of salicylate in the blood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Dosage and administration, Neurotoxic agents, Salicylates

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Increased serum IgE level and interleukin-4 release from cultured lymphocytes from a patient with adult onset Still's disease

Article Abstract:

Elevated levels of the antibody immunoglobulin-E (IgE) and another immune response mediator called interleukin-4 (IL-4) may contribute to the fever seen in patients with adult onset Still's disease (AOSD). AOSD is an inflammatory disorder characterized by arthritis in a number of joints and an enlarged spleen and lymph glands. Researchers analyzed blood samples taken from a 19-year-old patient with AOSD during and after two fever episodes. They tested the blood samples for antibody and immune protein levels. IgE and IL-4 levels increased more than 7-fold and 20-fold, respectively, during the second fever episode as compared to levels during remission. Levels of other antibodies such as IgG, IgA, and IgM were normal. Treatment with non-steroidal anti-inflammatory drugs (NSAIDS) relieved the symptoms.

Case studies, Measurement, Rheumatoid arthritis, Interleukin-4, Immunoglobulin E

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Increased erythrocyte aggregation as an indicator for an aggressive clinical course in Behcet's disease: a prospective study

Article Abstract:

Patients with Behcet's disease who develop vascular and visual complications may have increased red blood cell clumping. Behcet's disease is an inflammatory disease characterized by skin ulcerations, arthritis, eye inflammation, and blood vessel clots and blockages. Researchers compared red cell aggregation characteristics in 38 Behcet's disease patients and 40 healthy volunteers. Erythrocyte aggregation was more extensive in patients with vascular and ocular complications of Behcet's than in those with skin and joint symptoms alone, or in healthy people. Measuring red cell aggregation in Behcet's patients may indicate which ones are likely to develop eye and blood vessel complications.

Turkey, Complications and side effects, Physiological aspects, Behcet's disease, Behcet's syndrome, Erythrocytes, Red blood cells, Cell aggregation

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