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Child suffering from kawasaki disease. Taking medicine. How long medicine should be continued?

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Pediatrician, Cardiology
Practicing since : 2006
Answered : 1802 Questions
dear doctor,
my daughter is a 2 years old and she suffered from the the Kawasaki disease few weeks back and due to that it impacted on her hurt. now she is on 1 mg acitrom and 75mg ecosprin. her INR on 16th (one week earlier) was 1.25. can you tell me 1) what is the relationship in between INR and doses of Acitrom and ecosprin. 2) what is the standard INR of a normal person not having a acitrom. 3) is there any chance that she might get rid off from these tablets in future
Posted Wed, 13 Feb 2013 in Blood Disorders
Answered by Dr. Pradeep Kumar 2 hours later

Kawasaki disease is an immunological disorder and is usually diagnosed by a constellation of clinical and laboratory parameters.

Cardiac involvement is the most important manifestation of KD. This can be heart failure, myocarditis, valvular involvement or coronary artery involvement.
Treatment duration depends on the type of involvement of heart. If there is involvement of coronary artery, then treatment duration will be more in comparison to those in whom there is only myocarditis and valvular abnormalities. Coronary artery involvement is seen in 25% of cases only.

Now the main modality of treatment is immunoglobulin and high dose aspirin in acute stage and low dose aspirin during recovery phase. Anticoagulants like acitrom is used in cases in which there is high risk of thrombosis.

Acitrom is an anticoagulant( blood thinner) and ecospirin is an anti platelet drug.
Both drugs are indicated in KD as there is increased chance of thrombosis.

Normal INR value in this age group is 0.96-1.04, but a high INR is desired in such cases for therapeutic effect of medication. Usually INR 2-3 is needed for desired effect and this can be achieved by titrating (increasing in a step wise manner like 20% then 10%) the dose of anticoagulant.

Usually treatment is continued for 6-8 weeks if there is no coronary involvement. But it may be continued for prolonged duration if there is coronary problem. Now this duration depends on the severity of coronary involvement and can be assessed by repeated echocardiography.

I hope this answers your query well. I will be happy to answer if you have any further query.

Wish your child a speedy recovery.

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