title: Decreased protein binding of salicylates in Kawasaki disease.
abstract: Because patients with Kawasaki disease have low serum concentrations of salicylates despite high doses, and because the free (unbound) drug is responsible for the pharmacologic effects of salicylates, we assessed salicylate protein binding in patients with Kawasaki disease. During the acute phase of the disease, protein binding of salicylate in 36 children with Kawasaki disease was 73 +/- 12%, significantly lower than during the subacute phase (90.4 +/- 8.7%; p less than 0.0005). Mean serum albumin concentration was 29.2 +/- 6.4 gm/L during the acute phase and 36.7 +/- 7.8 gm/L during the subsequent subacute phase (p less than 0.005). Salicylate protein binding was affected independently by both serum albumin and total salicylate levels. During the acute phase of Kawasaki disease, children had an average twofold increase in free salicylate compared with normoalbuminemic control subjects. A nomogram has been devised to derive free salicylate levels from the known total salicylate and serum albumin concentrations.
authors.affiliation: Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Koren
authors.forename: E
authors.initials: E
authors.lastname: Silverman
authors.forename: R
authors.initials: R
authors.lastname: Sundel
authors.forename: P
authors.initials: P
authors.lastname: Edney
authors.forename: J W
authors.initials: JW
authors.lastname: Newburger
authors.forename: J
authors.initials: J
authors.lastname: Klein
authors.forename: I
authors.initials: I
authors.lastname: Robieux
authors.forename: R
authors.initials: R
authors.lastname: Laxer
authors.forename: E
authors.initials: E
authors.lastname: Giesbrecht
authors.forename: J C
authors.initials: JC
authors.lastname: Burns
mesh_terms: D000208:Acute Disease; D000328:Adult; D002250:Carbon Radioisotopes; D002648:Child; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000188:drug therapy; D011485:Protein Binding; D012459:Salicylates / Q000008:administration & dosage / Q000032:analysis / Q000097:blood*; D012709:Serum Albumin / Q000032:analysis / Q000378:metabolism*; D014462:Ultrafiltration
chemical_list: D002250:Carbon Radioisotopes; D012459:Salicylates; D012709:Serum Albumin