Treatment of Kawasaki Disease using the Intravenous Aspirin Anti-inflammatory Effect of Salicylate

Serum salicylate concentrations were measured in 60 patients with acute phase Kawasaki disease (KD), who were treated with intravenous aspirin (IVASP), to evaluate its antiinflammatory effect in the treatment of KD. Patients with serum salicylate concentrations ± 150μg/ml showed shorter durations of fever (7.1 ± 2.0 vs 10.4 ± 6.6 days; P < 0.05), shorter durations of positive serum C-reactive protein (14.6 ± 4.5 vs 22.3 ± 10.6 days; P < 0.01) and lower incidences of coronary arterial involvements (0/10 vs 6/24; P < 0.05) than did patients with serum salicylate concentrations < 150μg/ml. Significant linear correlations were recognized between daily IVASP dosage and serum salicylate concentrations ( r = 0.73; P < 0.01), and between serum salicylate concentrations and serum free salicylate concentrations ( r = 0.82; P < 0.01). These correlations did not differ between the presence and absence of coronary arterial involvements. Based on these findings we concluded that a beneficial anti-inflammatory effect in the treatment of KD is achieved when the serum salicylate concentration is 150μg/ml, and that such concentrations could be achieved by increasing the daily IVASP dosage to 100 mg/kg per day or more.