Kawasaki Disease or Incomplete Kawasaki Disease Clinical Pathway — Emergency Department and Inpatient
Aspirin has been used in the treatment of KD for its anti-inflammatory activity at high doses and anti-platelet activity at low doses. There is no evidence that aspirin decreases the incidence of coronary artery abnormalities, and there is no data to suggest that a high vs. moderate dose of aspirin is superior. The AHA guidelines state it is reasonable to administer moderate- or high-dose aspirin until the patient is afebrile, although there is no evidence it reduces coronary artery aneurysms.
This pathway does not recommend high-dose aspirin in those already receiving steroids, since steroids offer a powerful anti-inflammatory effect. This pathway suggests transitioning to low-dose ASA after 24 hours to allow for better assessment of fever and treatment resistance prior to discharge.
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American Heart Association. 2017 Mar: Circulation 135:00-00. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. McCrindle et al.