Korean J Pediatr Infect Dis.  2004 Nov;11(2):170-175. 10.14776/kjpid.2004.11.2.170.

Kikuchi-Fujimoto Disease with Prolonged Fever in Children

• Yeon YH
• Lee KY

• KMID: 2440063
• DOI: http://doi.org/10.14776/kjpid.2004.11.2.170

Abstract

PURPOSE
We experienced 7 patients with Kikuchi-Fujimoto disease(KFD) who had presented a prolonged fever and lymphadenopathy. The clinical and the laboratory aspects of the patients were analyzed.
METHODS
The medical records of the 7 KFD patients, who were confirmed by excisional lymph node biopsy from January 1996 through December 2003, were retrospectively analyzed.
RESULTS
The mean age of the children was 11.4±2.8 years(ranging from 8 to 15 years). The male to female ratio was 1.3 : 1. The median duration of the fever prior to admission and the total duration of the fever were 12 days(ranging from 5 to 65 days) and 27 days(ranging 9 to 75 days), respectively. One patient had supraclavicular lymphadenopathy, 5 had cercical involvement, and 1 had axillary lymphadenopathy. All the histologic findings of the lymph nodes biopsies showed the characteristic findings consistent with KFD such as paracortical necrosis with karyorrhexis and an increase in the number of phagocytic histiocytes and atypical lymphocytes. As for the laboratory findings, leukopenia(3,800±700/mm³), anemia(hemoglobin, 11.0±1.2 g/dL), an elevated erythrocyte sedimentation rate(42±17 mm/hr), and a relatively low C-reactive protein level(1.3±0.9 mg/dL) were noted. Four patients received conservative therapy with antipyretics, and 3 patients were treated with prednisolone.
CONCLUSION
KFD is a rare disease, yet should be considered in the differential diagnosis for older children with prolonged fever and lymphadenopathy.

Keyword

Kihuchi-Fujimoto disease; Subacute necrotizing lymphadenitis; Prednisolone

MeSH Terms

Antipyretics
Biopsy
Blood Sedimentation
C-Reactive Protein
Child*
Diagnosis, Differential
Female
Fever*
Histiocytes
Histiocytic Necrotizing Lymphadenitis*
Humans
Lymph Nodes
Lymphatic Diseases
Lymphocytes
Male
Medical Records
Necrosis
Prednisolone
Rare Diseases
Retrospective Studies
Antipyretics
C-Reactive Protein
Prednisolone