Salicylate treatment in Kawasaki disease: high dose or low dose?
Salicylate is the basic therapy for Kawasaki disease, however its optimal dose is controversial. We investigated the therapeutic efficacy of high dose (100 mg/kg per day, n = 30) versus low dose (30 mg/kg per day, n = 30) salicylate. Duration of fever, SGPT, serum salicylate, plasma thromboxane B2 (TxB2) and 6-keto-prostaglandin F1 alpha (PGF1 alpha) levels were compared before enrollment and on days 4, 7 and 14 of treatment. In the high dose group, duration of fever was significantly shorter than that of the low dose group (3.2 +/- 0.3 versus 5.4 +/- 0.8 days, P less than 0.05), however, SGPT levels were significantly elevated (157 +/- 34 versus 48 +/- 11 IU/1, P less than 0.05). No differences in the incidence of coronary artery lesions were observed (5/30 versus 7/30). Plasma TxB2 production was completely blocked in both groups, and plasma 6-keto-PGF1 alpha levels in the high dose group on day 14 was lower than that in the low dose group (39 +/- 8 versus 159 +/- 65 pg/ml, P less than 0.05). SGPT and plasma 6-keto-PGF1 alpha correlated with serum salicylate concentration. These data suggest that high dose salicylate therapy may be disadvantageous as anti-thrombotic therapy, and supports the notion that low dose therapy is safe in the acute stage of Kawasaki disease.
Akagi
T
T
Department of Paediatrics and Child Health, Kurume University School of Medicine, Japan.
Kato
H
H
Inoue
O
O
Sato
N
N
D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood; D000410:Alanine Transaminase / Q000097:blood; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012459:Salicylates / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D020156:Salicylic Acid; D013929:Thromboxane B2 / Q000097:blood
D012459:Salicylates; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha; D000410:Alanine Transaminase; D020156:Salicylic Acid