Soonchunhyang Med Sci.  2018 Dec;24(2):175-180. 10.0000/sms.2018.24.2.175.

Comparative Study between High Dose Aspirin and Ibuprofen in the Treatment of Kawasaki Disease in the Acute Stage

• Lee SJ
• Yoo GH

• KMID: 2437869
• DOI: http://doi.org/10.0000/sms.2018.24.2.175

Abstract

OBJECTIVE
Reye's syndrome can be caused by high dose of aspirin which is for treatment of acute phase of Kawasaki disease. We evaluated the effectiveness of treatment and coronary complications of replacing high dose of aspirin with ibuprofen for children in acute phase of Kawasaki disease.
METHODS
Children with Kawasaki disease (n=235) were admitted in the pediatric department from January 1, 2015 to December 31, 2017. Echocardiography and laboratory tests were performed during admission, and the children were followed-up at 6-8 weeks after the onset. We retrospectively analyzed their characteristics and clinical outcomes.
RESULTS
The children were assigned to receive either high dose of aspirin with intravenous immunoglobulin (IVIG) (aspirin group) or ibuprofen with IVIG (ibuprofen group). A total of 119 and 116 children were included in the aspirin and ibuprofen groups. Total fever duration was 6.5±1.6 days in the aspirin group, and 6.5±1.7 days in the ibuprofen group (P=0.674). The number of resistance to initial treatments was 11 in the aspirin group and 11 in the ibuprofen group (P=0.571). There were 13 initial coronary complications in the aspirin group, and 10 in the ibuprofen group (P=0.552) and children who showed coronary artery abnormalities improvement at 6- to 8-week follow-up was seven and five in the aspirin and ibuprofen groups, respectively (P=0.769).
CONCLUSION
We may consider using ibuprofen in acute phase of Kawasaki disease to prevent the severe complications of aspirin use, such as Reye's syndrome in the case concerning influenza or varicella.

Keyword

Mucocutaneous lymph node syndrome; Aspirin; Ibuprofen

MeSH Terms

Aspirin*
Chickenpox
Child
Coronary Vessels
Echocardiography
Fever
Follow-Up Studies
Humans
Ibuprofen*
Immunoglobulins
Immunoglobulins, Intravenous
Influenza, Human
Mucocutaneous Lymph Node Syndrome*
Retrospective Studies
Reye Syndrome
Aspirin
Ibuprofen
Immunoglobulins
Immunoglobulins, Intravenous