title: Is high-dose aspirin necessary in the acute phase of kawasaki disease?
abstract: OBJECTIVE
  We sought to determine whether high-dose aspirin is necessary for the acute therapy of Kawasaki disease (KD) in the intravenous immunoglobulin (IVIG) era.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Ewha Womans University School of Medicine, Mokdong Hospital, Seoul, Korea.
authors.forename: Goni
authors.initials: G
authors.lastname: Lee
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Hong
authors.forename: Sejung
authors.initials: S
authors.lastname: Sohn
keywords: Aspirin; Kawasaki disease; Therapeutics