Diagnosis of Kikuchi-Fujimoto Disease Based on Ultrasound and Clinical Findings

Kikuchi-Fujimoto disease (KFD) shares similar clinical manifestations and ultrasonic features with non-specific reactive lymphadenopathy (NSRL). This study aims to elucidate the independent predictors distinguishing these two diseases. A total of 136 lymph nodes (136 patients) with pathologically proven KFD from January 2015 to December 2019 were included. The control group comprised 117 NSRL lymph nodes (117 patients). Clinical information and imaging features were collected and analyzed. The main complaints of KFD were fever (84.6%). The patients with KFD and immune system diseases were older and had longer duration of symptoms. No significant differences (p< 0.05) were observed in sex, white blood cell count, short and long axis, shape, and margin. A binary logistic regression analysis revealed that the independent diagnostic factors were patient age (odds ratio [OR]=3.120, p=0.008), fever or pain (OR=0.100, p=0.038), failure of empirical antibiotic or antiviral therapy (OR= 305.88, p<0.001), vascular pattern (OR=0.049, p=0.042), CRP (OR=2.679, p=0.035), laterality (OR=0.352, p=0.020), and loose conglomeration (OR=3.605, p=0.019). The combined diagnosis effectiveness was 88.9%. Fever/pain, age range of 20-32 years, increased CRP, ineffective empirical treatment, loose conglomeration, unilateral, and non-abnormal vascular pattern were independent predictors.