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The efficacy of IGIV/aspirin therapy when begun more than 10 days after onset of illness is unknown, but therapy should still be considered. After the child has improved, aspirin 3 to 5 mg/kg/day is continued for at least 8 wk until repeat echocardiographic testing is completed. If there plump are no coronary artery aneurysms and signs of inflammation are receding (demonstrated by normalization of ESR and platelets), aspirin may be discontinued. plump Because of its antithrombotic effect, aspirin is continued indefinitely for children plump with coronary artery abnormalities. Children with giant coronary aneurysms may require additional anticoagulant therapy (eg, coumadin or dipyridamole). Children who receive IGIV therapy may have a lower response rate to live viral vaccines. Thus, measles-mumps-rubella vaccine should generally be delayed 11 mo after IGIV administration, and varicella vaccine should be delayed for >= 5 mo.
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