Mucocutaneous lymph-node syndrome (Kawasaki disease): probable soluble-complex disorder.

Abstract

Mucocutaneous lymph-node syndrome (Kawasaki disease): probable soluble-complex disorderThe first description in English of the mucocutaneous lymph-node syndrome (MLNS)l was followed by reports from Hawaii, Canada, the United States, and, recently, Britain.We report a further case. Case reportA previously healthy 22-month-old Japanese boy born in Osaka had lived in England for 17 months.He became ill with fever, redness of the hands and feet, and a rash on the trunk and limbs and then developed facial oedema with diarrhoea and vomiting.He was admitted to hospital on the eighth day because of pain and swelling of the neck and inability to swallow.The patient was feverish, drowsy, and dehydrated, and had neck stiffness, facial oedema, conjunctivitis, cracked, bleeding lips, a red pharynx with prominent tongue papillae, and pronounced cervical adenitis.As the rash faded peripheral oedema became evident and was followed by a striking desquamation of the fingers spreading to the hands and arms.He returned home on the 22nd day, and five days later similar desquamation began on the toes and feet.During the second month we noted a transverse groove on the nails of the fingers and toes.At no time could we detect any abnormality of the cardiovascular system.He was given intravenous fluids and benzyl- penicillin for 48 hours followed by cloxacillin for 48 hours until a diagnosis was made on the fourth day.Numerous investigations on blood, urine, cerebrospinal fluid, and faeces failed to yield a pathogenic organism.The table gives the results of haematological studies.