Characteristics of Kikuchi–Fujimoto disease in children compared with adults

Abstract

Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting disease characterized by cervical lymphadenopathy. Although it was primarily thought to be a disease of young adults, it has been increasingly recognized in children. To define the characteristics of KFD in children, we reviewed the medical records of patients younger than 18 years of age who were diagnosed with KFD from 2001 to 2012 at Korea University Medical Center, as well as worldwide published reports of KFD. A total of 140 pediatric patients and 733 patients of all ages was analyzed. Compared to the female predominance found in adults (2:1), young boys were more commonly affected than young girls (1.4:1). Cervical lymphadenopathy was the most common clinical finding in children, as it was in adults. Lymphadenopathy was more likely to be tender (69 vs. 44 %, p < 0.001) but less generalized (1 vs. 8 %, p < 0.05) in children compared to adults. Fever (82 vs. 35 %, p < 0.001) and rash (10 vs. 4 %, p < 0.05) were observed in children more commonly than in adults. Leukopenia was observed in 50 and 38 % of children and adults, respectively. Rates of recurrence and association with autoimmune diseases in children were comparable to those of adults. Cervical lymphadenopathy was the most common clinical manifestation of KFD in all ages. While fever and rash were more common in children with KFD compared to adults, generalized lymphadenopathy was rarer.

Kikuchi-Fujimoto disease in the regional lymph nodes with node metastasis in a patient with tongue cancer: A case report and literature review

“…In addition, KFD is difficult to diagnose with fine-needle aspiration (13,54–57). Although recurrent lymphadenopathy suggests a diagnosis of KFD on clinical grounds, this may not be confirmed by pathological examination following LN excision (13,51), and some studies have reported a diagnosis of recurrent KFD based on clinical findings alone, without rebiopsy (3,13,42,51,58). The diagnostic criteria for recurrent KFD are therefore obscure.…”

“…Up until 2013, 733 patients with KFD have been reported (3). Most patients with KFD present with localized unilateral cervical lymphadenopathy (axillary and inguinal are infrequently) with or without pain and fever (4).…”

Kikuchi Fujimoto Disease: The First Reported Case in Mongolia

“…Following the initial descriptions of KFD in 1972, approximately 740 cases have been reported in the literature [4]. Of those cases, 593 (81%) were adult patients, and male to female ratio was 1:2 in adults, but young boys were more commonly affected than girls (1.4:1) [4,5]. During the 1990's, researchers noted that women were affected four times more than men by this disease, and this female predominance attracted attention from the science community, however, recent reports from Eastern countries have suggested that the actual ratio is closer to 1:1 [1, [6][7][8].…”

Association between Kikuchi-Fujimoto disease and Streptococcus pneumoniae infection

“…Literature discusses both viral and autoimmune causes as the most likely. The role for viruses like Epstein-Barr virus, human herpesvirus 6 and 8, parvovirus B-19, parainfluenza and paramyxoviruses is controversial and, unremarked [5,6]. KFD has also been reported in patients with AIDS [7].…”

“…Although a slight female predominance was considered, the recent literature regards it as male to female ratio 1:1 [4]. A slightly male predominance has been reported in most paediatric studies [5].…”