Salicylate Intoxications in Children

Overview

Salicylate intoxications in children were the most frequent, or belonged to the most frequent of all drugintoxications in the past. In the majority of cases they presented as therapeutic intoxications. That was the reasonfor a greater interest of clinicians in this pharmacological group. Besides, there was a relationship on the incidenceof Reye’s syndrome and salicylate administration in paediatric practice. Immediately after discovery of thisconnection, the use of acetylsalicylic acid (ASA) preparations was limited and salicylate intoxications in childrenalmost disappeared.The authors describe the incidence of severe salicylate intoxications in 16 patients, who were hospitalized at theClinic of Paediatrics and Adolescent Medicine in Martin Faculty Hospital in 1967 - 1996. The children were infantsor toddlers (17 days up to 7 years, mean age 17 months). Intoxication symptoms comprised in all patients theconsciousness disorders (somnolence, spasms, coma), hyperpyrexia or fever, acidotic or Kussmaul breathing. 13children were cured without any consequences, one child died, one child became paralyzed and in one childdeveloped epilepsy. In all children the intoxication was therapeutic.Nowadays therapeutic ASA intoxications are very rare. Suicidal intoxication (often combined) in older childrenare usually therapeutically controlled without any consequences. The intoxication with repeated therapeutic dosesof ASA, especially in younger children, is caused by its cumulation in the organism as well as by specific metabolicdifferences. The accumulation is the result of reduced renal excretion during dehydration (the children refuse todrink fluids) and acidosis.The salicylate intoxications are indirectly dependent on the drug dose. Reye’s syndrome is usually presentindependently on the dose of administered ASA.

Key words:
acetylsalicylic acid, intoxication in children, salicylates