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• W1973294180 abstract "Kawasaki disease is a systemic vasculitis of unknown etiology, usually affecting infants and young children, with a predilection for the coronary arterial system. Without treatment, approximately 20% of affected children will develop either coronary artery aneurysms or ectasia. The incidence of coronary artery changes decreases to about 5% when patients are treated with appropriate doses of intravenous gamma globulin and aspirin prior to the 10th day of the illness. The combination of disease-induced coagulation abnormalities and abnormal flow dynamics in the affected coronary arteries makes anticoagulation therapy necessary during the acute phase of the disease. The need for anticoagulation therapy is life-long in patients with persistent coronary artery abnormalities. During the acute phase of the illness in the uncomplicated child, aspirin is used for anticoagulation therapy. More aggressive anticoagulation therapy is recommended for those patients with giant (>8 mm) coronary artery aneurysms. Although the results are mixed, thrombolytic therapy is frequently used for those patients who develop coronary artery thrombi. Aspirin remains the mainstay of long-term anticoagulation therapy in patients with persistent coronary artery abnormalities, with warfarin added in those patients with giant aneurysms. As experience with new antiplatelet agents increases and they are shown to be safe and effective in preventing thrombi in adults with coronary artery disease, the potential choices for both acute and long-term anticoagulation in children with Kawasaki disease may also increase. In this review, coagulation abnormalities in children with Kawasaki disease, anticoagulation in the acute phase of the disease, thrombolytic therapy in patients with coronary artery thrombi, and long-term anticoagulation in patients with persistent coronary artery changes will be summarized." @default.
• W1973294180 created "2016-06-24" @default.
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• W1973294180 creator A5077049877 @default.
• W1973294180 creator A5086648639 @default.
• W1973294180 date "2004-12-01" @default.
• W1973294180 modified "2023-10-15" @default.
• W1973294180 title "Anticoagulation in the acute and long-term management of Kawasaki disease" @default.
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• W1973294180 doi "https://doi.org/10.1016/j.ppedcard.2004.08.012" @default.
• W1973294180 hasPublicationYear "2004" @default.
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