Also called mucocutaneous lymph node syndrome, this disorder of unknown origin occurs mainly in children under five and was first described in Japan. It is characterised by high fever, conjunctivitis (see under EYE, DISORDERS OF), skin rashes and swelling of the neck glands. After about two weeks, the skin may peel from fingertips and toes. The disease may last for several weeks before spontaneously resolving. It is possible that it is caused by an unusual immune response to INFECTION (see IMMUNITY).
is a common complication and can result in the development of coronary artery aneurysms (see ANEURYSM). These aneurysms, and even myocardial infarction (see HEART, DISEASES OF – Coronary thrombosis), are often detected after the second week of illness. The disease can be hard to diagnose as it mimics many childhood viral illnesses, especially in its early stages. The incidence in the UK is over 3 per 100,000 in children under five years of age.
Because of the danger of coronary artery disease, prompt treatment is important. This is with intravenous IMMUNOGLOBULINS and low-dose aspirin. To be effective, treatment must start in the first week or so of the illness – a time when it is most difficult to diagnose. Those who do not respond may be offered further immunoglobulin and CORTICOSTEROIDS.