High-Dose Aspirin is Associated with Anemia and Does Not Confer Benefit to Disease Outcomes in Kawasaki Disease

Kawasaki disease (KD) is also known as multiple mucocutaneous lymph node syndrome of systemic vasculitis and is a leading cause of coronary artery lesions (CAL) in childhood. Intravenous immunoglobulin (IVIG) has been proven to effectively reduce the incidence of CAL, but the role and effect dose of...

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Bibliographic Details
Published in:PloS one 2015-12, Vol.10 (12), p.e0144603-e0144603
Main Authors: Kuo, Ho-Chang, Lo, Mao-Hung, Hsieh, Kai-Sheng, Guo, Mindy Ming-Huey, Huang, Ying-Hsien
Format: Article
Language:English
Subjects:
Analysis
Anemia
Anemia - chemically induced
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Aspirin
Aspirin - adverse effects
Aspirin - therapeutic use
Bleeding
C-Reactive Protein - analysis
Child
Child, Preschool
Children
Complications and side effects
Coronary artery
Coronary vessels
Data processing
Dosage and administration
Dose-Response Relationship, Drug
Drug dosages
Drug therapy
Drug Therapy, Combination
Female
Fever
Gallbladder
Health care facilities
Hemoglobin
Hemoglobins - analysis
Hepcidin
Hepcidins - blood
Hospitals
Humans
Immunoglobulins
Immunoglobulins, Intravenous - therapeutic use
Immunologic Factors - therapeutic use
Inflammation
Intravenous administration
Kawasaki disease
Kawasaki syndrome
Lesions
Leukocyte Count
Leukocytes
Male
Medical services
Medicine
Mucocutaneous lymph node syndrome
Mucocutaneous Lymph Node Syndrome - blood
Mucocutaneous Lymph Node Syndrome - drug therapy
Patient outcomes
Patients
Pediatrics
Retrospective Studies
Risk factors
Systemic vasculitis
Treatment Outcome
Vasculitis
Veins & arteries
White blood cells
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Summary:Kawasaki disease (KD) is also known as multiple mucocutaneous lymph node syndrome of systemic vasculitis and is a leading cause of coronary artery lesions (CAL) in childhood. Intravenous immunoglobulin (IVIG) has been proven to effectively reduce the incidence of CAL, but the role and effect dose of aspirin in KD is still unclear. Moreover, overt bleeding and anemia are associated with the use of aspirin, and anemia is common in patients with KD. Thus, the aim of this study was conducted to compare the treatment efficacy, degree of anemia and inflammation, and changes in serum hepcidin in children who received a combination of high-dose aspirin and IVIG in the acute stage of KD, and those who received IVIG alone. KD patients from two medical centers were retrospectively analyzed from 1999-2009. All patients were initially treated with a single dose of IVIG (2 g/kg) as the standard care of treatment. In group 1, high-dose aspirin was prescribed (> 30 mg/kg/day) until the fever subsided, and then low-dose aspirin (3-5 mg/kg/day) was prescribed until all the inflammation signs had resolved. In group 2, low-dose aspirin was prescribed without high-dose aspirin. Laboratory data were collected for analysis in both groups. A total of 851 KD patients (group 1, N = 305, group 2, N = 546) were enrolled in this study. There were no significant differences between group 1 and group 2 in terms of gender (p = 0.51), IVIG resistance rate (31/305 vs. 38/546, p = 0.07), CAL formation (52/305 vs. 84/546, p = 0.67), and duration of hospitalization (6.3 ± 0.2 vs. 6.7 ± 0.2 days, p = 0.13). There were also initially no significant differences in total white blood cell count, hemoglobin level, platelet count, and CRP before IVIG treatment between groups (all p>0.1). After IVIG treatment, group 1 had significantly lower levels of hemoglobin (p = 0.006) and higher CRP (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0144603