Salicylate-induced hepatitis in rheumatic fever

In a 4 1/2-year retrospective study of hospitalized patients with rheumatic fever treated with salicylates, we determined that five of 34 children manifested salicylate-induced hepatitis. The average serum salicylate level in those patients with hepatotoxicity was 30.9 mg/dL, while the average serum salicylate level in the rest of the patients was 19.7 mg/dL. An awareness of this potential complication is important when treating children with salicylates at doses previously considered to be nontoxic. Serum salicylate levels should be maintained at approximately 15 to 25 mg/dL during such therapy.