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Original Article

Clinical Observations of Kikuchi-Fujimoto Disease in Children and Adolescents: A Single Center Experience

Hee Won Kang, Han Wool Kim, Soyoung Lee, Kyung Ha Ryu, Hae Soon Kim, Eun Sun Yoo, Hee Jung Choi1, Kyung-Hyo Kim
The Ewha Medical Journal 2018;41(4):75-81. Published online: October 29, 2018

Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea.

1Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

Corresponding author: Kyung-Hyo Kim. Department of Pediatrics, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea. Tel: 82-2-2650-2857, Fax: 82-2-2650-2817, kaykim@ewha.ac.kr
• Received: March 8, 2018   • Revised: August 14, 2018   • Accepted: August 16, 2018

Copyright © 2018. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    Kikuchi-Fujimoto disease (KFD) is characterized by lymphadenopathy and fever, and is usually self-limited. This study analyzed the clinical characteristics of pediatric patients with KFD.
  • Methods
    This retrospective, observational, single-center study was conducted in South Korea from March 2008 to October 2015. KFD was diagnosed based on clinical, radiological or histological findings and excluded when there were any other causes of lymphadenopathy. Medical records were reviewed for clinical and laboratory manifestations.
  • Results
    A total of 35 cases were included. The mean patient age was 12.1±2.9 years (range, 5 to 17 years); the male-to-female ratio was 1:0.8. The main clinical manifestations were cervical lymphadenopathy and fever in 34 cases (97%). The mean duration of fever was 12.2±8.3 days (range, 2 to 37 days). We noted enlargement of lymph nodes in the cervical, mesenteric (n=5, 14%), axillary (n=2, 6%), and inguinal (n=1, 3%) regions. Hepatosplenomegaly, loss of appetite, and rash were observed. On laboratory examinations, elevation of ferritin, leukopenia, and positivity for anti-nuclear antibodies were frequently observed. Twelve patients underwent biopsy and 23 cases were diagnosed by radiological findings. The mean duration of hospitalization for all cases was 7.9±2.9 days (range, 3 to 13 days) and steroids were administered in 10 cases. KFD recurrence was observed in 2 cases (5.7%) with the time to relapse of 7 months and 4 years. There were no cases with systemic lupus erythematous or other autoimmune disease.
  • Conclusion
    KFD should be considered in pediatric patients with lymphadenopathy and prolonged fever. Patients with KFD should be monitored for recurrence and the development of autoimmune disease.
  • Keywords: Histiocytic necrotizing lymphadenitis; Lymphadenopathy; Pediatrics; Fever
Supplementary Table is available from: https://doi.org/10.12771/emj.2018.41.4.75

Supplementary Table 1

Location of involved lymph nodes of patients with Kikuchi-Fujimoto disease
emj-41-75-s001.pdf
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Table 1

Clinical characteristics of patients diagnosed with Kikuchi-Fujimoto disease

Values are presented as number of cases (%) or mean±SD (range) unless otherwise indicated.

*Not recorded in 13 cases.

†Accompanied by cervical lymphadenopathy except only one case of axillary lymphadenopathy.

‡The mesenteric lymph node involvement was examined by imaging studies (computed tomography or sonography) on 14 patients, five of them were detected.

emj-41-75-i001.jpg
Table 2

Laboratory and radiologic findings of patients diagnosed with Kikuchi-Fujimoto disease

ANA, antinuclear antibody; EBV, Epstein-Barr virus; CMV, cytomegalovirus; MTBC, mycobacterium tuberculosis complex.

emj-41-75-i002.jpg
Table 3

Duration of hospitalization according to treatment

emj-41-75-i003.jpg

Figure & Data

References

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    • Kikuchi-Fujimoto Disease Mimicking Mesenteric Lymphadenitis in Children: A Case Report and Systematic Review
      Gyeongseo Jeon, Si-Hwa Gwag, Young June Choe, Saelin Oh, Jun Eun Park
      Pediatric Infection & Vaccine.2023; 30(1): 39.     CrossRef

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    Clinical Observations of Kikuchi-Fujimoto Disease in Children and Adolescents: A Single Center Experience
    Ewha Med J. 2018;41(4):75-81.   Published online October 29, 2018
    DOI: https://doi.org/10.12771/emj.2018.41.4.75
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    Clinical Observations of Kikuchi-Fujimoto Disease in Children and Adolescents: A Single Center Experience
    Ewha Med J. 2018;41(4):75-81.   Published online October 29, 2018
    DOI: https://doi.org/10.12771/emj.2018.41.4.75
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    Clinical Observations of Kikuchi-Fujimoto Disease in Children and Adolescents: A Single Center Experience
    Clinical Observations of Kikuchi-Fujimoto Disease in Children and Adolescents: A Single Center Experience

    Clinical characteristics of patients diagnosed with Kikuchi-Fujimoto disease

    Values are presented as number of cases (%) or mean±SD (range) unless otherwise indicated.

    *Not recorded in 13 cases.

    †Accompanied by cervical lymphadenopathy except only one case of axillary lymphadenopathy.

    ‡The mesenteric lymph node involvement was examined by imaging studies (computed tomography or sonography) on 14 patients, five of them were detected.

    Laboratory and radiologic findings of patients diagnosed with Kikuchi-Fujimoto disease

    ANA, antinuclear antibody; EBV, Epstein-Barr virus; CMV, cytomegalovirus; MTBC, mycobacterium tuberculosis complex.

    Duration of hospitalization according to treatment
    Table 1 Clinical characteristics of patients diagnosed with Kikuchi-Fujimoto disease

    Values are presented as number of cases (%) or mean±SD (range) unless otherwise indicated.

    *Not recorded in 13 cases.

    †Accompanied by cervical lymphadenopathy except only one case of axillary lymphadenopathy.

    ‡The mesenteric lymph node involvement was examined by imaging studies (computed tomography or sonography) on 14 patients, five of them were detected.

    Table 2 Laboratory and radiologic findings of patients diagnosed with Kikuchi-Fujimoto disease

    ANA, antinuclear antibody; EBV, Epstein-Barr virus; CMV, cytomegalovirus; MTBC, mycobacterium tuberculosis complex.

    Table 3 Duration of hospitalization according to treatment

    Table 1

    Table 2

    Table 3

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