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Characterization of Kikuchi-Fujimoto Disease in Children and Risk Factors Associated with Its Course
Sujin Choi1, Hyoung Soo Choi1, Young Jin Ryu2
1Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
Insights
Kikuchi-Fujimoto disease (KFD) in children typically presents with lymph node enlargement and fever. Corticosteroids may help manage severe symptoms like high-grade fever, oral ulcers, or anemia, but recurrence monitoring is essential.
Area of Science:
- Pediatric Infectious Diseases
- Pediatric Rheumatology
- Histopathology
Background:
- Kikuchi-Fujimoto disease (KFD) is a rare, benign, self-limiting condition that primarily affects lymph nodes.
- Understanding the clinical spectrum and management of KFD in pediatric populations is crucial for appropriate patient care.
Purpose of the Study:
- To characterize Kikuchi-Fujimoto disease (KFD) in children.
- To identify factors associated with severe or recurrent disease courses.
Main Methods:
- Retrospective review of electronic medical records for pediatric KFD cases diagnosed between March 2015 and April 2021.
- Analysis of clinical presentation, laboratory findings, treatment interventions, and patient outcomes.
Main Results:
- 114 pediatric KFD cases were identified, with common symptoms including cervical lymphadenopathy (97.4%) and fever (85%).
- High-grade fever (≥39°C) occurred in 62% and prolonged fever (≥14 days) in 44.3%.
- Corticosteroid use was associated with oral ulcers and anemia; 10.5% experienced recurrence, with no identified risk factors.
Conclusions:
- Clinical characteristics of pediatric KFD remained consistent over an 18-year period.
- Corticosteroid intervention may benefit children with high-grade fever, oral ulcers, or anemia.
- Continuous monitoring for KFD recurrence in pediatric patients is recommended.
Objective:
To outline the characteristics of Kikuchi-Fujimoto disease (KFD) in children and analyze factors associated with severe and recurring courses.
Methods:
Electronic medical records of children histopathologically diagnosed with KFD at Seoul National University Bundang Hospital from March 2015 to April 2021 were retrospectively reviewed.
Results:
A total of 114 cases (62 males) were identified. The mean patient age was 12.0 ± 3.5 years. Most patients came to medical attention with cervical lymph node enlargement (97.4%) and fever (85%); 62% had a high-grade fever (≥39°C). Prolonged fever (≥14 days) was seen in 44.3% and was associated with a high-grade fever (P = .004). Splenomegaly, oral ulcer, or rash was present in 10.5%, 9.6%, and 15.8%, respectively. Laboratory findings showed leukopenia, anemia, and thrombocytopenia in 74.1%, 49%, and 24%, respectively. Sixty percent of cases had a self-limited course. Antibiotics were initially prescribed in 20%. A corticosteroid was prescribed in 40% of patients and was associated with oral ulcer (P = .045) and anemia (P = .025). Twelve patients (10.5%) had a recurrence with a median interval of 19 months. No risk factor for recurrence was identified in multivariable analysis. Clinical characteristics of KFD were similar between our current and previous studies. However, antibiotics use decreased (P < .001); nonsteroidal anti-inflammatory drugs use increased (P < .001), and, although statistically not significant, corticosteroid treatment also increased.
Conclusions:
Over a span of 18 years, the clinical characteristics of KFD did not change. Patients presenting with high-grade fever, oral ulcer, or anemia may benefit from corticosteroid intervention. All patients should be monitored for recurrence.
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