Korean Circ J.  2013 Mar;43(3):182-186. 10.4070/kcj.2013.43.3.182.

Is High-Dose Aspirin Necessary in the Acute Phase of Kawasaki Disease?

• Lee G
• Lee SE
• Hong YM
• Sohn S

• KMID: 2224962
• DOI: http://doi.org/10.4070/kcj.2013.43.3.182

Abstract

BACKGROUND AND OBJECTIVES
We sought to determine whether high-dose aspirin is necessary for the acute therapy of Kawasaki disease (KD) in the intravenous immunoglobulin (IVIG) era.
SUBJECTS AND METHODS
Two groups of KD patients treated during the different periods were included. Study group (n=51, treated with IVIG without concomitant use of aspirin in the acute phase) was compared with control group (n=129, treated with IVIG plus high-dose aspirin) with regard to the response to IVIG, duration of fever after IVIG completion, time to C-reactive protein (CRP) <3 mg/dL, and the incidence of coronary artery lesions (CALs).
RESULTS
There was no difference between the groups in age, sex, and duration of fever before treatment. Pre-IVIG laboratory measures also did not differ from each other. IVIG-resistant cases were 8 (15.7%) in study group and 22 (17.1%) in control group (p=1.000). Mean duration of fever after IVIG completion in IVIG-responsive patients was 13.3+/-13.5 hours in study group compared to 6.2+/-8.3 hours in control group (p=0.000). The mean time to decrease in CRP was 4.0+/-1.7 days in study group and 4.1+/-2.2 days in control group (p=0.828). There were 2 (3.9%) patients with CALs in study group and 10 (7.8%) in control group (p=0.514).
CONCLUSION
Although high-dose aspirin shortens the duration of fever, treatment without aspirin in the acute phase has no influence on the response to IVIG, resolution of inflammation, or the development of CALs. In the IVIG era, high-dose aspirin may provide little benefit to the treatment in the acute phase of KD.

Keyword

Kawasaki disease; Aspirin; Therapeutics

MeSH Terms

Aspirin
C-Reactive Protein
Coronary Vessels
Fever
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Incidence
Inflammation
Mucocutaneous Lymph Node Syndrome
Aspirin
C-Reactive Protein
Immunoglobulins
Immunoglobulins, Intravenous

Figure

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  Fig. 1 The prevalence of fever in the acute phase of Kawasaki disease after intravenous immunoglobulin (IVIG) therapy without aspirin in 43 IVIG-responsive patients.

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