ABSTRACT
From 1976 to 1985, a total of 58 infants and children with the hemolytic-uremic syndrome were randomly assigned to treatment either with heparin and dipyridamole or with supportive management only. In the treatment group, two patients died in the early weeks of the disease. Analysis of clinical and laboratory data showed no significant difference between either group of patients as to the evolution of their illness except for a significantly higher incidence of anuria and a significantly faster recovery from hypertension in the treated group. Renal biopsy studies showed no differences between the two groups in terms of incidence and severity of the histologic lesions. The long-term data on blood pressure and creatinine clearance values in the survivors were similar in both groups. This study indicates that treatment with heparin and dipyridamole has no benefit over symptomatic therapy alone in the typical form of childhood hemolytic-uremic syndrome.
Subject(s)
Dipyridamole/therapeutic use , Hemolytic-Uremic Syndrome/drug therapy , Heparin/therapeutic use , Adolescent , Anuria/chemically induced , Child , Child, Preschool , Dipyridamole/adverse effects , Drug Therapy, Combination , Female , Hemolytic-Uremic Syndrome/complications , Heparin/adverse effects , Humans , Hypertension/etiology , Infant , Male , Prospective Studies , Random Allocation , Time FactorsABSTRACT
Cortes de aorta "exaurida" de ratos, foram incubados por 20 min. em temperatura ambiente, com plasma de seis pacientes urêmicos em hemodiálise de manutençäo, com plasma de 23 hepatopatas e com plasma de voluntários sadios. Observou-se que plasma de pacientes urêmicos e de hepatopatas, estimularam a liberaçäo de prostaciclina em grau maior do que o plasma dos normais. A liberaçäo aumentada de prostaciclina pode ter um papel na patogênese da diátese hemorrágica dos pacientes com insuficiência renal ou hepática
Subject(s)
Adult , Middle Aged , Rats , Animals , Male , Female , Aorta/blood , Blood Coagulation Disorders , Epoprostenol/metabolism , Liver Diseases/blood , Renal Insufficiency, Chronic/bloodABSTRACT
Exhausted rat aorta slices were incubated for 20 minutes at room temperature with plasma from 6 uremic patients undergoing maintenance hemodialysis, from 23 patients with hepatic disorders and with plasma from healthy volunteers. We observed that plasma from uremic as well as from patients with liver dysfunction stimulated prostacyclin release more than the simultaneously studied normal plasmas. Enhanced prostacyclin release may play a role in the pathogenesis of the hemorrhagic diathesis of patients with renal or hepatic failure.