Clinical Presentations, Laboratory Results and Outcomes of Patients with Kikuchi's Disease: Emphasis on the Association Between Recurrent Kikuchi's Disease and Autoimmune Diseases
Journal
Journal of Microbiology, Immunology and Infection
Journal Volume
43
Journal Issue
5
Pages
366-371
Date Issued
2010
Author(s)
Abstract
Background/Purpose: Kikuchi's disease (KD), also known as histiocytic necrotizing lymphadenitis, is a benign and self-limiting disease of unknown etiology that mainly affects young women. There is limited data on the long-term prognosis of patients with KD. Methods: We describe the clinical manifestations and outcomes of 195 patients, diagnosed as having KD at National Taiwan University Hospital from March 1989 to September 2006. Results: All together, 53.3% of our patients presented with tender lymphadenopathy, 37.9% with fever and 16.9% with headache. The most common laboratory findings were elevated erythrocyte sedimentation rate (78.9%), elevated serum lactate dehydrogenase (52.5%), elevated C-reactive protein (38.3%), monocytosis (26.9%), elevated serum alanine aminotransferase (23.3%) and leukopenia (18.9%). A total of 183 patients followed a benign course, with spontaneous resolution of fever and lymphadenopathy. However, 14 patients (14.6%) with follow-up of more than 6 months had clinical recurrence of KD; hence, long-term follow-up is suggested. Five of these patients developed an autoimmune disease, namely, systemic lupus erythematosus (n = 2), Graves' disease (n = 2), or mixed connective tissue disease (n = 1). One patient with recurrent KD died of intracranial hemorrhage due to thrombocytopenia. Conclusion: The prognosis for KD patients is generally optimistic; however, a concurrent autoimmune disease or the risk of developing an autoimmune disease requires careful monitoring. ? 2010 Taiwan Society of Microbiology.
SDGs
Other Subjects
alanine aminotransferase; antibiotic agent; C reactive protein; lactate dehydrogenase; nonsteroid antiinflammatory agent; paracetamol; steroid; adolescent; adult; alanine aminotransferase blood level; antibiotic therapy; arthralgia; article; autoimmune disease; brain hemorrhage; child; chill; clinical feature; coughing; disease association; disease course; epigastric pain; erythrocyte sedimentation rate; female; fever; follow up; Graves disease; headache; human; human tissue; Kikuchi disease; laboratory test; lactate dehydrogenase blood level; leukopenia; long term care; lymph node biopsy; lymphadenopathy; major clinical study; malaise; male; mixed connective tissue disease; monocytosis; night sweat; preschool child; prognosis; rash; recurrent disease; rhinorrhea; school child; sore throat; steroid therapy; systemic lupus erythematosus; thrombocytopenia; university hospital; upper respiratory tract infection; weight reduction; Adolescent; Adult; Autoantibodies; Autoimmune Diseases; Child; Female; Fever; Follow-Up Studies; Histiocytic Necrotizing Lymphadenitis; Humans; Lymphatic Diseases; Male; Middle Aged; Prognosis; Recurrence; Retrospective Studies; Taiwan; Treatment Outcome; Young Adult
Type
journal article