Possible Role of <i>Streptococcus Pyogenes</i> in Mucocutaneous Lymph Node Syndrome

Abstract

Abstract Migration inhibitory factor (M1F)‐induced activity of patients with mucocutaneous lymph node syndrome (MCLS) to antigens associated with Streptococcus pyogenes infection was compared to that of control populations consisting of children with illnesses not related to streptococcal infections (group A), and of patients with streptococcal pharyngitis (group B), with the following results. 1. Though a consiaerable number of patients in the acute state of MCLS failed to respond to antigens consisting of (1) a coccus preparation of S. pyogenes (Picibanil), (2) streptococcal pyrogenic exotoxin (SPE) and (3) an extract from cells of a virally transformed human B‐cell line, a complete restoration of their responsiveness was observed in parallel with the decrease of fever. 2. While almost all patients of group A were refractory not only to Picibanil and SPE but also to the extract from the transformed human cells, some children with infections due to intracellular microbes showed responsiveness to the extract from the transformed cells. 3. In group B, some patients showed a marked responsiveness and the other a complete refractoriness to these antigens throughout the observation period. These results raise the possibility that S. pyogenes may play a principal role in the pathogenesis of MCLS.