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Kikuchi's disease in Asian children
Hsin-Ching Lin1, Chih-Ying Su, Shun-Chen Huang
1Department of Otolaryngology, Chang Gung University, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan. hclin@adm.cgmh.org.tw <hclin@adm.cgmh.org.tw>
Pediatrics
|January 5, 2005
Summary
Kikuchi's disease (KD) in children typically presents as posterior cervical lymphadenopathy and resolves within six months. This study found a male predominance in pediatric cases, contrasting with adult KD, and highlights the need for long-term monitoring for systemic lupus erythematosus.
Area of Science:
- Pediatric Pathology
- Immunology
- Rheumatology
Background:
- Kikuchi's disease (histiocytic necrotizing lymphadenitis) is a rare, self-limiting lymphadenopathy primarily affecting the head and neck.
- It typically occurs in young adults with a female predilection.
Purpose of the Study:
- To review the institutional experience with Kikuchi's disease in pediatric patients.
- To analyze clinical features, laboratory values, and long-term outcomes in children diagnosed with KD.
Main Methods:
- Retrospective review of 23 pediatric patients (<16 years) diagnosed with KD via cervical lymph node biopsy between 1986 and 2002.
- Analysis of clinical presentation, pathological findings, and an average 8-year follow-up period.
Main Results:
- The study identified 23 pediatric patients (8 female, 15 male) with a mean age of 12.8 years.
- All cases involved posterior cervical lymph nodes, with unilateral involvement in 82.6%.
- Leukopenia and fever were observed in 21.7% and 30.4% of patients, respectively; one patient developed systemic lupus erythematosus 5 years later. Lymphadenopathy resolved within 6 months in most cases without treatment, with no recurrences noted.
Conclusions:
- Kikuchi's disease should be considered in the differential diagnosis of pediatric posterior cervical lymphadenopathy, particularly in Asian children.
- Pediatric KD exhibits a male predominance, contrary to adult cases.
- Children diagnosed with KD require systemic evaluation and long-term follow-up to monitor for potential development of systemic lupus erythematosus.