The incidence and clinical characteristics by gender differences in patients with Kikuchi–Fujimoto disease

Abstract

Kikuchi–Fujimoto disease (KFD) is a rare, self-limiting disorder that typically affects the cervical lymph nodes (LNs). Although initially described in young women, KFD also occurs in men. There are no reports on the clinical manifestations and characteristics of male KFD patients. Therefore, this study was conducted to assess the incidence of KFD among males, as well as the most frequent clinical characteristics of these patients. A retrospective, cross-sectional study was performed at a tertiary hospital of patients pathologically confirmed as having KFD from LN biopsy specimens. Clinical and laboratory data, and treatment outcomes of the enrolled patients, were analyzed by gender. A total of 254 patients diagnosed with KFD were enrolled. There were 189 females and 65 males (2.9:1). The mean age was 32.6 ± 11.3 years. Compared to the female patients, the males had more frequent manifestations of fever (48% vs 67%, P = 0.008), headache (9% vs 20%, P = 0.013), bilateral lymphadenopathy (31% vs 46%, P = 0.029), thrombocytopenia (14% vs 29%, P = 0.014), elevated C-reactive protein (CRP) (35% vs 78.4%, P < 0.001), elevated liver enzymes (15% vs 41%, P < 0.001), and elevated lactate dehydrogenase (LDH) (61% vs 80%, P = 0.021). Male patients had fewer autoimmune features (9% vs 2%, P = 0.043) and fewer positive antinuclear antibodies (32% vs 10%, P = 0.006). In this study, 25.6% of the enrolled patients were male, with a 2.9:1 female-to-male sex ratio. Male patients showed a distinctive profile characterized by a higher frequency of fever, headache, bilateral lymphadenopathy, and thrombocytopenia, as well as elevated liver enzymes, CRP, and LDH.

Kikuchi-Fujimoto disease: a rare cause of cervical lymphadenopathy and fever

“…There is a large Korean study of 254 patients by Jung et al that suggested gender differences in clinical and laboratory manifestation 10. In the study, women were more likely to have autoimmune features and positive ANA, while men were more likely to have fever, headache, bilateral lymphadenopathy, thrombocytopaenia, raised CRP, raised LDH and liver derangement.…”

Case report on a rare entity–Kikuchi Fujimoto Disease (KFD) in a person with underlying Systemic Lupus Erythematosus (SLE)

“…2 Most commonly affects young people under 30 years of age, with equal incidence in both sexes. 3 Usually presents as painless cervical lymphadenopathy with constitutional symptoms. Associated hepatomegaly, leukopenia, increased erythrocyte sedimentation rate (ESR), increased liver enzyme levels.…”

Association Kikuchi disease with Hashimoto thyroiditis: a case report and literature review

“…Kim et al [ 16 ] reported that the development of autoimmune disease was diagnosed in approximately 4% in children with KFD. In an adult study, 7% of KFD patients had autoimmune disease [ 17 ]. Although the exact mechanism by which KFD and other autoimmune disease were related is unknown, but based on laboratory and histological findings, it has been hypothesized that KFD might represent an exuberant T-cell-mediated response to certain antigen stimuli in genetically susceptible individuals [ 14 ].…”