Aspirin in Kawasaki disease

Aspirin in Kawasaki disease

Aspirin in Kawasaki disease is given both for its anti inflammatory effect and antiplatelet effect. In the early stage it is for anti inflammatory effect while later it is for antiplatelet effect in case of coronary artery involvement. Anti inflammatory dose is high and is given only for a short period. Only low dose is needed for antiplatelet effect and is given for a longer period. Some studies have also raised questions about the utility of aspirin in Kawasaki disease [1].

Aspirin – ibuprofen interaction

Ibuprofen can interfere with the antiplatelet effect of low dose aspirin and should be avoided in children needing low dose aspirin for its antiplatelet effect as with coronary aneurysms in Kawasaki disease.

Reye syndrome with aspirin

Reye syndrome is a potentially fatal situation with involvement of brain and liver which can occur in children on aspirin when they develop influenza or varicella. It has been reported in children taking high dose aspirin for a prolonged period in Kawasaki disease. But it is not clear whether low dose aspirin given for antiplatelet effect in case of coronary aneurysms also predisposes to Reye syndrome.

Similar concerns over Varicella vaccination has also been raised as manufacturers recommend avoiding aspirin for 6 weeks after vaccination. Substitution with other antiplatelet agents during this period has been suggested. Parents of children on long term aspirin should be advised to contact their physician if they develop influenza or varicella or even gets exposed to these illnesses.

Reference

  1. Sakulchit T, Benseler SM, Goldman RD. Acetylsalicylic acid for children with Kawasaki disease. Can Fam Physician. 2017 Aug;63(8):607-609. PMID: 28807954; PMCID: PMC5555326.