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Kikuchi-Fujimoto disease in children
Shoba N Selvanathan1, Sharline Suhumaran2, Vinay K Sahu1,3,4,5
1Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
Insights
Kikuchi-Fujimoto disease (KFD) in children is more common in boys and recurs in 12.2% of cases. Long-term monitoring is recommended for potential recurrence and development of systemic lupus erythematosus.
Area of Science:
- Pediatric Infectious Diseases
- Rheumatology
- Histopathology
Background:
- Kikuchi-Fujimoto disease (KFD) is a rare, self-limiting condition characterized by cervical lymphadenopathy.
- It primarily affects children and young adults, presenting diagnostic challenges due to its varied clinical manifestations.
- Understanding KFD's pediatric epidemiology and clinical course is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics of pediatric Kikuchi-Fujimoto disease.
- To determine the recurrence rate of KFD in children.
- To identify potential risk factors or associations with KFD recurrence.
Main Methods:
- Retrospective study of pediatric patients diagnosed with KFD between January 2000 and September 2017.
- Inclusion criteria: patients under 18 years with histological confirmation of KFD from lymph node biopsy.
- Data collection included patient demographics, clinical presentation, laboratory findings, treatment, and follow-up outcomes.
Main Results:
- A total of 98 pediatric patients (52 boys, 46 girls) were identified, with a median age of 11.2 years.
- KFD recurred in 12.2% of patients, with recurrent cases more likely to be hospitalized and present with fever initially.
- One patient (1%) developed systemic lupus erythematosus 10 years post-KFD diagnosis.
Conclusions:
- Kikuchi-Fujimoto disease in children shows a higher incidence in males and a significant recurrence rate of 12.2%.
- A small percentage of pediatric KFD patients may develop systemic lupus erythematosus, highlighting the need for long-term surveillance.
- Continued follow-up is recommended to monitor for KFD recurrence and associated autoimmune conditions.
Aim:
Kikuchi-Fujimoto disease (KFD) is an important cause of lymphadenitis in children. The primary aim of this study was to investigate the clinical characteristics of children with KFD and to assess the recurrence of this disease.
Methods:
This is a retrospective study of patients younger than 18 years old, who were diagnosed with KFD from January 2000 to September 2017 at KK Women's and Children's Hospital. Records of children with a histological diagnosis of KFD from a lymph node biopsy were obtained from the Department of Pathology. Case notes and electronic medical records of the patients were reviewed. Data collected included patient characteristics, symptoms, clinical and laboratory findings, treatment and follow-up.
Results:
A total of 98 patients were identified. There were 52 boys and 46 girls with a median age of 11.2 years old. Recurrence occurred in 12 (12.2%) patients. One patient developed systemic lupus erythematosus 10 years after diagnosis of KFD. Recurrent cases were more likely to be managed as an inpatient and have fever at presentation of their first episode of KFD.
Conclusion:
In our study, KFD in children had a higher prevalence among boys, and had a recurrence rate of 12.2%, with 1% of patients developing systemic lupus erythematosus. We recommend that patients be followed up for recurrence and advised to monitor for symptoms of recurrence.
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