Kawasaki Disease or Incomplete Kawasaki Disease Clinical Pathway — Emergency Department and Inpatient
Antiplatelet Therapy
Aspirin has been used in the treatment of KD for its anti-inflammatory activity at high doses (early in the disease) and anti-platelet activity at low doses (for chronic thromboprophylaxis). 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 a better assessment of fever and treatment resistance prior to discharge.
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2nd Line Thrombosis Prevention |
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Special Considerations |
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Reference