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Clinical outcome and predictive factors of recurrence among patients with Kikuchi's disease
Joon Young Song1, Jacob Lee, Dae Won Park
1Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Korea University Guro Hospital, 97 Guro Dong-Gil, Guro Gu, 152-703 Seoul, Republic of Korea.
Objectives:
To evaluate the clinical outcome and predictive factors of recurrence among patients with Kikuchi's disease.
Methods:
Between January 2001 and December 2006, all patients with Kikuchi's disease were included in the study. Data were collected on co-morbidities, clinical manifestations, and ultrasound/laboratory findings, and the differences were compared between recurrent disease and non-recurrent disease groups.
Results:
The study included 102 patients with a mean age of 26.7 years. Among these patients, three developed systemic lupus erythematosus during the follow-up period, while two cases were later associated with tuberculosis. Eight patients (7.8%) experienced early relapse and 13 (12.7%) showed late recurrence. Patients with recurrent episodes were more likely to have fever and fatigue with extranodal involvement. Compared to the non-recurrent cases, recurrent cases remained symptomatic for a rather longer duration. The positive rate of the fluorescence anti-nuclear antibody (FANA) test was significantly higher in the recurrent disease group compared to the non-recurrent disease group.
Conclusions:
Kikuchi's disease took a self-limiting clinical course in most cases, but the recurrence rate found in the present study was higher than that of previous reports. Kikuchi's disease might be a phenotype of diverse disease entities. The prognosis is different according to the underlying cause. The FANA test would be useful in predicting recurrence.
