A Study on the Optimal Dose of Aspirin Therapy in Kawasaki Disease: Clinical Evaluation and Arachidonic acid Metabolism

Aspirin is the basic treatment for Kawasaki disease, however its optimal dose is controversial. We investigated the therapeutic efficacy of high-dose (lOOmg/kg/day, n = 30) versus low-dose (30 mg/kg/day, n = 30) aspirin. Duration of fever, trasaminase, plasma thromboxane B2 (TXB₂) and 6-keto-prostaglandin F₁α (PGF₁α) levels were compared before enrollment and on days 4, 7 and 14. In the high-dose group, duration of fever was significantly shorter than that of low-dose group (3.2±1.8 versus 5.4±4.3 days, p<0.05), however, serum glutamic pyruvic transaminase levels were elevated (157.4 ± 187.7 versus 48.0± 58.21. U./liter, p<0.005). No differences in the incidence of coronary artery lesions were observed (5 of 30 versus 7 of 30). Plasma T_xB₂ production was completely blocked in both groups, plasma 6-keto-PGF₁α levels in the high-dose group on day 14 was lower than that in the low-dose group (39 α26 versus 160 α207 pg/ml, p<0.05). This latter observation suggest that high-dose therapy may be disadvantageous as anti-thrombotic treatment, and supports the notion that low dose therapy is safe in the acute stage of Kawasaki disease.