Kikuchi Disease in Korean Children : Clinical Features and Disease Courses
BACKGROUND: Kikuchi’s disease (KD) is a benign disorder with lymphadenopathy, and prevalent in young Asian women. The presentations mimic some serious diseases, and the biopsy of lymph nodes is the only definite diagnostic tool. We analyzed data from a series of pediatric cases and suggest proper guideline of management. METHODS: The medical records of children under 16 years of age, who underwent lymph node biopsies and received histiopathologic diagnosis of KD at Ajou University Hospital, South Korea from January 2000 to June 2007, were retrospectively reviewed. RESULTS: Twenty six pediatric patients with KD included 10 boys and 16 girls. Twenty (76.9%) patients had fever as a presenting symptom, and 5 patients (19.2%) had various skin rash. Eleven (55%) cases with fever improved after excision biopsy of lymph nodes. Eight (30.8%) cases treated with steroid showed dramatic responses. Six patients (23.1%) had resolutions of symptoms simply with symptomatic treatments. The recurrence happened in 6 (23.1%) children within a few weeks from the first episode. CONCLUSIONS: KD in Korean children is not rare in young boys, and fever is more common presenting symptoms. Symptoms improved only by the removal of lymph node for excision biopsy. Patients treated with steroid recovered dramatically. We suggest an earlier excision biopsy for patients suspicious with KD and an immediate treatment of cases with severe symptoms with steroid. The recurrence rate in this study was higher than that in previous studies, therefore, a spell of follow-up period after disappearance of symptoms is advisable for patients with KD.
Kikuchi disease, Histiocytic necrotizing lymphadenitis, Lymphadenopathy, Children
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