Abstract
Background: Acetylsalicylic acid (ASA) is part of the recommended treatment of Kawasaki disease (KD). Controversies remain regarding the optimal dose of ASA. We aimed to evaluate the impact of different doses of ASA on inflammation control while minimizing adverse effects in the acute phase treatment of KD. Methods: The enrolled 323 patients with KD were divided into three groups according to ASA dose: moderate-dose (30–50 mg/kg/day), high-dose (80–100 mg/kg/day), and non-ASA. Results: High-dose ASA group showed a significantly shorter duration of fever from the start of treatment to remission than other groups. Baseline level and delta score of interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor-α, and transforming growth factor β were not statistically different among the groups. The number of patients who received additional treatments in the non-ASA group was more than other groups. Coronary artery dilatation was not significantly different among the groups. One patient with high-dose ASA was diagnosed with Reye syndrome. Conclusion: Different doses of ASA did not show any differences in changes of inflammatory bio-makers and cytokines. However, high-dose ASA showed occurrence of Reye syndrome, and non-ASA showed intravenous immunoglobulin refractoriness. We suggest that moderate-dose ASA may be beneficial for the treatment of patients in the acute phase of KD.
Highlights
Kawasaki disease (KD) is an acute, self-limited systemic vasculitis in children
We aimed to evaluate the impact of different dose of Acetylsalicylic acid (ASA) on inflammation control while minimizing adverse effects in the acute phase treatment of KD
The present study showed no difference in laboratory parameters among the groups after Intravenous immunoglobulin (IVIG) treatment and no significant differences in the incidence of coronary artery dilatation (CAD) according to the ASA dose
Summary
Kawasaki disease (KD) is an acute, self-limited systemic vasculitis in children. KD is characterized by fever, erythema of the palms of the hands and soles of the feet, skin rash, bilateral non-exudative conjunctivitis, strawberry tongue, lip redness, and cervical lymphadenopathy.Vasculitis in KD characteristically occurs in medium-sized arteries, which are primarily the coronary arteries, and can lead to coronary artery dilatation (CAD) or coronary artery aneurysm (CAA). Intravenous immunoglobulin (IVIG) is the standard treatment for the prevention of coronary artery lesions in the acute phase of KD. We aimed to evaluate the impact of different doses of ASA on inflammation control while minimizing adverse effects in the acute phase treatment of KD. Methods: The enrolled 323 patients with KD were divided into three groups according to ASA dose: moderate-dose (30–50 mg/kg/day), high-dose (80–100 mg/kg/day), and non-ASA. Results: High-dose ASA group showed a significantly shorter duration of fever from the start of treatment to remission than other groups. Coronary artery dilatation was not significantly different among the groups. One patient with high-dose ASA was diagnosed with Reye syndrome. High-dose ASA showed occurrence of Reye syndrome, and non-ASA showed intravenous immunoglobulin refractoriness.
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