Mucocutaneous Lymph Node Syndrome (Kawasaki Disease) in Adults

To the Editor.— The case reports presented by E. Dale Everett, MD (242:542, 1979), purports to describe adult cases of mucocutaneous lymph node syndrome (Kawasaki disease). Before this association becomes ingrained in the general medical literature, I would like to urge a note of caution. Mucocutaneous lymph node syndrome was originally described in Japanese children, and its epidemiology in Japan strongly emphasizes its rarity in persons older than 5 years. Its diagnostic criteria are sufficiently broad to include many other distinct clinical entities (eg, Stevens-Johnson's syndrome, scarlet fever, and leptospirosis) if clinical criteria are interpreted too liberally or a full etiologic evaluation is not completed. Even from the case descriptions given, Everett's patients differ from those with Kawasaki disease in a number of the following important ways: they are adult and female, and they have a more acute and severe multisystem illness. In most respects, these cases are far more