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Clinical characteristics and risk factors for recurrence of Kikuchi-Fujimoto disease in children: a case-control
Bing Liu1, Yi Sun1, Wen-Yuan Shi2
1Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, National Center for Children's Infectious and Allergic Diseases Surveillance, Beijing Research Center for Respiratory Infectious Diseases, Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, 100045, China.
Background:
This study was performed to summarize the clinical and laboratory features of children with Kikuchi-Fujimoto disease (KFD). The risk factors of KFD recurrence were analyzed.
Methods:
A retrospective case-control study was conducted on children who underwent lymph node biopsy in the department of infectious diseases of Beijing Children's Hospital from April 2018 to April 2022. The clinical manifestations and treatment of children with KFD were summarized, and the clinical characteristics of children with KFD and the control group were compared. The clinical characteristics of FANA (fluorescent antinuclear antibody) positive group and FANA negative group in children with KFD were compared. The children with KFD were divided into recurrence group and non-recurrence group, and the risk factors for recurrence of KFD were analyzed.
Results:
A total of 359 children with lymph node biopsy were included in the study, including 239 children with KFD. The ratio of male to female was 1.85:1 and the average age was (9.78 ± 2.91) years. Two hundred and thirty-five (98.3%) KFD children had fever and two hundred and thirty-six cases (98.7%) of KFD children had cervical lymph node enlargement. A total of 208 (87.0%) KFD children had a decrease in white blood cell count during the course of the disease. The proportions of lymph node enlargement with tenderness, oral ulcer and leucopenia in the KFD group were significantly higher than those in the control group (P < 0.05). The proportion of multiple lymph node involvement in the KFD group was significantly lower than that in the control group (P < 0.05). Among the 239 cases, 51 cases (21.3%) were treated with corticosteroid and 10 received intravenous immunoglobulin therapy. Among the 239 patients with KFD, 30 (12.6%) had recurrence and 12 of them had recurrence within 3 months after discharge. In univariate analysis, recurrence was associated with positive antinuclear antibody and corticosteroid therapy (P < 0.05).No risk factor for recurrence was identified in multivariable analysis (P > 0.05).
Conclusions:
KFD in children is more common in males and mostly occurs at school age. KFD in children is characterized by tenderness in the lymph node and leukopenia with less multiple lymph node involvement. All patients should be monitored for recurrence.
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