Acute hemorrhagic, hepatic, and neurologic manifestations in juvenile rheumatoid arthritis: possible relationship to drugs or infection

J Pediatr. 1985 Apr;106(4):561-6. doi: 10.1016/s0022-3476(85)80072-x.


Seven children with juvenile rheumatoid arthritis had a syndrome characterized by hemorrhage and neurologic, hepatic, hematologic, and metabolic manifestations. The disease did not seem to conform clearly to the characteristics of Reye syndrome or any other well-known entity. This severe complication may be induced by macrophage activation secondary to a drug or intercurrent infection. Our data suggest that a sudden fall in erythrocyte sedimentation rate or in platelet and fibrinogen levels may mark the start of this complication and may be an indication for rapid steroid therapy.

MeSH terms

  • Acute Disease
  • Arthritis, Juvenile / drug therapy
  • Arthritis, Juvenile / physiopathology*
  • Aspirin / adverse effects
  • Bacterial Infections / complications*
  • Child
  • Child, Preschool
  • Coma / etiology*
  • Coma / physiopathology
  • Diagnosis, Differential
  • Female
  • Gold / adverse effects
  • Hemorrhage / etiology*
  • Hemorrhage / physiopathology
  • Hepatomegaly / etiology
  • Hepatomegaly / physiopathology
  • Humans
  • Infant
  • Liver Diseases / etiology*
  • Liver Diseases / physiopathology
  • Male
  • Reye Syndrome / diagnosis
  • Syndrome


  • Gold
  • Aspirin