PEDIATRICS Vol. 54 No. 3 September 1974, pp. 271-276
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A New Infantile Acute Febrile Mucocutaneous Lymph Node Syndrome (MLNS) Prevailing in Japan

Tomisaku Kawasaki M.D.1, Fumio Kosaki M.D.1, Sumio Okawa M.D.1, Itsuzo Shigematsu M.D.1, and Hiroshi Yanagawa M.D.1

1 Department of Pediatrics, Japan Red Cross Medical Center, and the Department of Epidemiology, Institute of Public Health, Tokyo

What may be a new disease has been afflicting infants and young children in Japan since 1960. It is an acute, febrile, mucocutaneous condition accompanied by swelling of cervical lymph nodes (tentatively called mucocutaneous lymph node syndrome [MLNS]). It may be misdiagnosed as scarlet fever, the Stevens-Johnson syndrome, or infantile periarteritis nodosa. The disease is now known to be widely occurring all over Japan with an increasing incidence each year. More than 6,000 cases have been reported as of 1973. One to two percent of the patients reported have died suddenly of cardiac failure. All the autopsies showed infantile periarteritis nodosa-like arteritis accompanied by coronary thrombosis and aneurysm. Some of the surviving cases have been shown to have similar changes. These findings lead us to believe that this clinical picture is a new clinical entity. Recently, rickettsia-like bodies were found by electron microscopy in biopsy specimens from the skin and lymph nodes of the patients. The bodies were isolated by yolk sac culture and their pathogenicity is now under investigation.

Submitted on October 19, 1973
Accepted on January 3, 1974


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H. MILGROM, E. L. PALMER, S. F. SLOVIN, D. M. MORENS, S. D. FREEDMAN, and J. H. VAUGHAN
Kawasaki Disease in a Healthy Young Adult
Ann Intern Med, April 1, 1980; 92(4): 467 - 470.
[Abstract] [PDF]

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A. J. NAHMIAS
Kawasaki Disease: From Children to Adults
Ann Intern Med, April 1, 1980; 92(4): 563 - 564.
[Abstract] [PDF]

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G. A. Caron
Kawasaki Disease in an Adult
JAMA, February 1, 1980; 243(5): 430 - 430.
[Abstract] [PDF]

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L. J. Anderson, D. M. Morens, and E. S. Hurwitz
Kawasaki Disease in a Young Adult
Arch Intern Med, February 1, 1980; 140(2): 280 - 280.
[Abstract] [PDF]

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W. H. NECHES and L. W. YOUNG
Mucocutaneous Lymph Node Syndrome: Coronary Artery Disease and Cross-sectional Echocardiography
Arch Pediatr Adolesc Med, December 1, 1979; 133(12): 1233 - 1235.
[Abstract] [PDF]

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H. Yoshida, T. Funabashi, S. Nakaya, and N. Taniguchi
Mucocutaneous Lymph Node Syndrome: A Cross-sectional Echocardiographic Diagnosis of Coronary Aneurysms
Arch Pediatr Adolesc Med, December 1, 1979; 133(12): 1244 - 1247.
[Abstract] [PDF]

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E. D. Everett
Mucocutaneous Lymph Node Syndrome (Kawasaki Disease) in Adults
JAMA, August 10, 1979; 242(6): 542 - 543.
[Abstract] [PDF]

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D. P. Speert, W. J. Britt, and E. L. Kaplan
Tick-Borne Tularemia Presenting as Ulcerative Lymphadenitis
Clinical Pediatrics, April 1, 1979; 18(4): 239 - 241.
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A. G. Barbour, G. G. Krueger, P. M. Feorino, and C. B. Smith
Kawasaki-like Disease in a Young Adult: Association With Primary Epstein-Barr Virus Infection
JAMA, January 26, 1979; 241(4): 397 - 398.
[Abstract] [PDF]

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J. J. Bitter, S. A. Friedman, R. L. Paltzik, and H. C. Mofenson
Kawasaki's Disease Appearing as Erythema Multiforme
Arch Dermatol, January 1, 1979; 115(1): 71 - 72.
[Abstract] [PDF]

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A. S. FAUCI, B. F. HAYNES, and P. KATZ
The Spectrum of Vasculitis: Clinical, Pathologic, Immunologic, and Therapeutic Considerations
Ann Intern Med, November 1, 1978; 89(5_Part_1): 660 - 676.
[Abstract] [PDF]

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G. Kahn
Mucocutaneous Lymph Node Syndrome (Kawasaki's Disease) A New Disease Remaking Its Debut
Arch Dermatol, June 1, 1978; 114(6): 948 - 950.
[PDF]

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I. MATSUDA, S. HATTORI, N. NAGATA, A. FRUSE, H. NAMBU, K. ITAKURA, and A. WAKISAKA
HLA Antigens in Mucocutaneous Lymph Node Syndrome
Arch Pediatr Adolesc Med, December 1, 1977; 131(12): 1417 - 1418.
[Abstract] [PDF]

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R. T. Rowe and R. T. Stone
Streptococcal Pharyngitis in Children: Difficulties in Diagnosis on Clinical Grounds Alone
Clinical Pediatrics, October 1, 1977; 16(10): 933 - 935.
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P. S. Bergeson and S. L. Schoenike
Mucocutaneous Lymph Node Syndrome: A Case Masquerading as Rocky Mountain Spotted Fever
JAMA, May 23, 1977; 237(21): 2299 - 2302.
[Abstract] [PDF]

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H. H. Hussey
Mucocutaneous Lymph Node Syndrome: Second Alert
JAMA, May 23, 1977; 237(21): 2326 - 2327.
[Abstract] [PDF]

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G. Hicsonmez, G. Kanra, H. Kocak, and S. Ozsoylu
Acute Febrile Mucocutaneous Lymph Node Syndrome
Clinical Pediatrics, May 1, 1977; 16(5): 480 - 481.
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R. B. Odom and E. G. Olson
Mucocutaneous Lymph Node Syndrome
Arch Dermatol, March 1, 1977; 113(3): 339 - 340.
[Abstract] [PDF]

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C. J. Siegel and H. A. Wenner
The Mucocutaneous Lymph Node Syndrome: Description of an Affected 21-Month-Old Child in Kansas City
Clinical Pediatrics, December 1, 1976; 15(12): 1105 - 1106.
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C. P. Darby and C. U. Kyong
Mucocutaneous Lymph Node Syndrome
JAMA, November 15, 1976; 236(20): 2295 - 2297.
[Abstract] [PDF]

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H. H. Hussey
Mucocutaneous Lymph Node Syndrome
JAMA, July 19, 1976; 236(3): 292 - 292.
[Abstract] [PDF]

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Mucocutaneous Lymph Node Syndrome: The Epidemiologic Approach Toward Finding Its Causation
Arch Pediatr Adolesc Med, June 1, 1976; 130(6): 593 - 594.
[Abstract] [PDF]

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D. J. Radford, H. M. Sondheimer, G. J. Williams, and R. S. Fowler
Mucocutaneous Lymph Node Syndrome With Coronary Artery Aneurysm
Arch Pediatr Adolesc Med, June 1, 1976; 130(6): 596 - 598.
[Abstract] [PDF]