A 3-year-old treated for Kawasaki disease 5 days ago is afebrile and recovering. Platelet count is 720,000 per microliter. Coronary arteries are normal on echocardiography. What aspirin regimen should be followed now?
- A Stop aspirin immediately since fever has resolved
- B High-dose aspirin until 6 weeks, then stop regardless of platelets
- C Low-dose aspirin 3 to 5 mg/kg/day until 6 to 8 weeks if coronaries remain normal ✓
- D Low-dose aspirin continued lifelong in all Kawasaki patients
Correct answer: C. Low-dose aspirin 3 to 5 mg/kg/day until 6 to 8 weeks if coronaries remain normal
Explanation
After defervescence, aspirin is reduced to the antiplatelet dose of 3 to 5 mg/kg/day and continued until the patient remains afebrile with normal coronary arteries, conventionally for 6 to 8 weeks. If coronary abnormalities persist, low-dose aspirin continues indefinitely. Stopping early leaves the child exposed to thrombotic risk during the peak thrombocytosis phase. Lifelong therapy is unnecessary when serial echocardiograms show normal coronaries at follow-up.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.