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Discussion Starter · #1 ·
A 16-year old child has been diagnosed with rheumatic fever. He now has painful migratory polyarthritis. The physician has decided to give penicillin for the RF, but should he also prescribe aspirin for the painful polyarthritis or would this increase the risk of Reye syndrome?

I apologize for not copying the question as-is from Kaplan Qbank, because I think this would violate copyrights.
 

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Yes I agree that aspirin is very effective in acute RF. However in about 20% under 16, high dose aspirin can cause liver toxicity and Reye's syndrome.

So I would be so careful. Only for short course.
 

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FDA states that no one under 19yo should take ANY form and ANY dose of salicylates i.e aspirin, or mesalamine. Thus, I wouldn't give aspirin at all
 

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Discussion Starter · #5 ·
FDA states that no one under 19yo should take ANY form and ANY dose of salicylates i.e aspirin, or mesalamine. Thus, I wouldn't give aspirin at all
That's what I've been eager to hear! :) And that's exactly what I sent to Kaplan medfeedback about this question. The designated right answer was penicillin + aspirin, but I did not agree.
 

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Kawasaki is the only disease where aspirin is used in under 16 year old in the UK.
 

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Discussion Starter · #10 ·
Kaplan's opinion

I emailed Kaplan about this, and here's their reply:

Even though aspirin use is found to be related to REYE'S syndrome in the children with viral infection, Aspirin is also the major anti-inflammatory agent for relief of symptoms due to acute rheumatic fever.
No doubt we should use aspirin cautiously in children and that is why it is advised as you can see from link you referred to that the opinion of a doctor or pharmacist be obtained before anyone under 19 years of age is given any medication containing aspirin.
So I guess it's OK to give aspirin to children in cases of RF .. :notsure:
 

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I emailed Kaplan about this, and here's their reply:

So I guess it's OK to give aspirin to children in cases of RF .. :notsure:
Well, I am sorry but the reply from Kaplan is totally frustrating. What we need to know is exactly what's the opinion that the doctor or pharmacist will have! I will go with the FDA. It's better to use an inferior NSAID than aspirin than cause fulminant hepatitis
 
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