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[Edema in acute diffuse glomerulonephritis, rheumatic peliosis and epidemic parotitis]
Insights
This study suggests chlorpromazine effectively treats infant conditions like APING and Schöenlein-Henoch vasculitis by improving cellular respiration and reducing inflammation. It also shows promise in Kawasaki disease and epidemic parotitis.
Area of Science:
- Pediatrics
- Nephrology
- Pharmacology
Background:
- Infant conditions like APING exhibit poor oxygen utilization and intracellular edema.
- Nephritic edema and hypervolemia suggest systemic cellular respiratory distress.
- Schöenlein-Henoch vasculitis and Kawasaki disease present with significant inflammatory symptoms.
Purpose of the Study:
- To investigate the efficacy of chlorpromazine in treating various pediatric inflammatory and respiratory conditions.
- To explore the role of chlorpromazine in managing symptoms associated with APING, Schöenlein-Henoch vasculitis, Kawasaki disease, and epidemic parotitis.
Main Methods:
- Venous blood gas analysis to assess oxygen utilization in APING.
- Clinical observation of edema, volemia, and capillary permeation.
- Case series evaluating chlorpromazine treatment for Schöenlein-Henoch vasculitis, Kawasaki disease, and epidemic parotitis.
Main Results:
- Chlorpromazine improved oxygen use and resolved oligoanuresis in APING.
- Rapid detumescence and resolution of petechiae/melena observed in Schöenlein-Henoch vasculitis with chlorpromazine.
- Favorable responses noted for chlorpromazine in Kawasaki disease and epidemic parotitis, reducing swelling and pain.
Conclusions:
- Chlorpromazine demonstrates significant therapeutic potential for systemic cellular respiratory suffering in infants.
- The drug effectively manages inflammatory manifestations in conditions like Schöenlein-Henoch vasculitis and epidemic parotitis.
- Chlorpromazine, potentially combined with acetylsalicylic acid, offers a promising treatment avenue for pediatric inflammatory diseases.
Abstract:
The Authors present a substantial series of infant APING in which the venous blood gas analysis shows poor use of oxygen, due to a probably reduced cellular combustion associated with low pCO2, high pH, which are characteristic of arterial blood travelling through anastomotic paths and preferential channels at the microcirculation level. They emphasize the contemporaneous increase in volemia, even with oedema present, and the poor permeation of the capillary wall found with the Landis test, contrary to what happens in glomerulonephrosis with minimal changes which features increased systematic capillary permeation with hypovolemia. The look of the oedema, together with the hypervolemia, led to the suspicion that the nephritic oedema was a sign of mainly intracellular oedema. In the opinion of the Authors these nephritic forms would seem to show systemic cellular respiratory suffering sensitive to the action of chlorpromazine, which has also dealt swiftly and cleanly with the oligoanuresis. The Authors consider 52 cases of Schöenlein-Henoch vasculitis which showed very rapid detumescence of periarticular swelling and those on the back of the hands and feet, as well as the disappearance of skin petechias and melena following treatment with chlorpromazine. They also mention two cases of Kawasaki's disease which seemed to react favorably to the combination of the action of chlorprmazine with acetylsalicylic acid. The effects obtained with chlorpromazine in 27 cases of epidemic parotitis with periscialoadenitis elastic tumescence are reported, with the focus on the reduction of the perisalivary tumescence. It is important to point out the very rapid disappearance of epigastrial pain, probably pancreatic in origin.(ABSTRACT TRUNCATED AT 250 WORDS)