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May 23, 1977

Mucocutaneous Lymph Node Syndrome: Second Alert

JAMA. 1977;237(21):2326-2327. doi:10.1001/jama.1977.03270480066027

An earlier JAMA editorial1 described the symptoms and course of mucocutaneous lymph node syndrome (MLNS), which is evidently a new disease or a mysterious variant of some other known disease. The editorial mentioned that what was formerly a "Japanese" disease affecting young children had been identified in widely separated areas of the United States and Canada and would be recognized more often.

The forecast has been substantiated; 1976 was the year for reporting cases of MLNS, and the nature of some of the reports suggests that diagnosis was made retrospectively. Furthermore, evidence has accrued to indicate underreporting rather than overreporting. For example, in this issue (p 2299) Bergeson et al describe the case of a 7-year-old girl in whom MLNS was accompanied by serologic findings that pointed to a diagnosis of Rocky Mountain spotted fever. The authors therefore wonder how often MLNS has been misidentified as Rocky Mountain spotted