How long to give Aspirin in Kawasaki Disease

Administration of moderate dose ASA (ASPRIN*) (30–50 mg/kg/d) is  given until the patient is afebrile and after Low-dose ASA (3–5 mg/kg/d) is continued as guided by Z scores on  ECHO as follows-

Z score < 2.0 (No coronary abnormality) the low dose aspirin is given for 6-8 weeks till all inflammatory parameters normalize.

Z score 2 to <2.5 the low dose aspirin is given for 6-8 weeks till all parameters normalize including the transient coronary dilatation.

Z score between  2.5 to <5 (Small Aneurysm), the  low dose aspirin is given for the long term with regular Pediatric Cardiologist & Rheumatologist  follow ups.

Z score 5 to <10 the low dose aspirin is given for long term and anticoagulants/antiplatelet(clopidogrel) may be added as guided by cardiologist, with close monitoring and follow up.

Z score is > 10 the child has to be given anticoagulation (Nicoumalone/ACITROM*) plus aspirin for long term and needs close monitoring as there is a high risk of thrombosis.

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