What is the difference between atypical Kawasaki disease and Kawasaki disease?

The main difference between atypical Kawasaki disease and Kawasaki disease is that the symptoms do not fully meet the diagnostic criteria of typical Kawasaki disease, but both are systemic vasculitis and may cause cardiovascular complications. Both require timely use of immunoglobulin and aspirin to prevent coronary artery disease.

1. Symptom Differences

The diagnostic criteria for typical Kawasaki disease include persistent high fever, bilateral conjunctival congestion, oral mucosal changes, hard swelling of the hands and feet, rash, and cervical lymphadenopathy. Atypical Kawasaki disease may lack some typical symptoms, such as only fever and mild rash, or only non-specific symptoms such as abdominal pain and joint pain. Due to the atypical symptoms, diagnosis is difficult and it is easy to be misdiagnosed as other diseases.

2. Diagnostic criteria

The diagnosis of typical Kawasaki disease is based on clear clinical criteria, while atypical Kawasaki disease requires the combination of laboratory tests and imaging results to assist in the diagnosis. In blood tests, elevated C-reactive protein and erythrocyte sedimentation rate are important indicators. Cardiac ultrasound examinations can detect coronary artery dilatation or aneurysms, which is the key basis for diagnosis.

3. Treatment

Whether it is typical or atypical Kawasaki disease, the core of treatment is to use high-dose immunoglobulin and aspirin as early as possible. Immunoglobulin can inhibit inflammatory response and reduce the risk of coronary artery disease. Aspirin has anti-inflammatory and anti-platelet aggregation effects. For patients with severe coronary artery disease, interventional treatment or surgery, such as coronary artery bypass grafting, may be required.

4. Prognosis and follow-up

After timely treatment, most patients have a good prognosis, but long-term follow-up is required to monitor heart function. Regular cardiac ultrasound examinations are performed to assess the status of the coronary arteries. For patients with coronary artery disease, they need to continue taking aspirin or other antiplatelet drugs and avoid strenuous exercise.

Atypical Kawasaki disease differs from typical Kawasaki disease in symptoms and diagnostic difficulty, but the treatment principles and prognosis management are similar. Early identification and intervention are the key to preventing serious complications. Parents and doctors need to be vigilant, especially for children with atypical symptoms. Laboratory and imaging tests should be combined to make a clear diagnosis and take timely treatment measures to ensure the health of the patient.