Probable efficacy of high-dose salicylates in reducing coronary involvement in Kawasaki disease
G. Koren, V. Rose, S. Lavi and R. Rowe
The efficacy of high-dose salicylates in reducing the coronary artery
involvement of Kawasaki disease was compared in 36 children who received
acetylsalicylic acid, 80 to 180 mg/kg/day, and in 18 who did not receive
high-dose salicylates during the febrile phase of the disease and whose
fever was controlled mainly with acetaminophen. The two groups were
comparable with respect to age and body weight. In the acetylsalicylic
acid-treated group, the dose was adjusted to meet the therapeutic serum
concentration range (greater than or equal to 20 mg/dL). There were
significantly more cases of coronary involvement in the nontreated group
(50%) than in the salicylate-treated group (16.6%) and of coronary
aneurysms (39% vs 3%). During the febrile phase of the disease, salicylate
serum concentrations achieved with a given dose were on the average twofold
lower than during the nonfebrile phase, owing to impaired absorption of
acetylsalicylic acid. It is suggested that despite the difficulty in
achieving therapeutic serum concentrations of salicylate during the febrile
phase of Kawasaki disease with a dose as high as 100 mg/kg/day, this dose
is potentially capable of preventing the associated coronary disease.
