Park Hyun Seok, Sung Min Jung, Park Su Eun, Lim Young Tak
Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea.
Pediatr Allergy Immunol. 2007 Mar;18(2):174-8. doi: 10.1111/j.1399-3038.2006.00505.x.
Kikuchi-Fujimoto disease (KFD) is subacute necrotizing lymphadenitis characterized by fever, leukopenia and cervical lymphadenopathy. There are few reports on the clinical characteristics and laboratory findings of KFD in the pediatric literature. In this study, we evaluate the characteristics and outcome of KFD in children. A total of 412 patients were studied with fever and peripheral lymphadenopathy at Pusan National University Hospital from January 1998 to December 2003. Among the total 412 there were 16 patients diagnosed with KFD by lymph node biopsy. We analyze the clinical, laboratory and outcome after review of the medical records retrospectively. The mean age of the patients was 10.6 +/- 3.4 yr (range: 4-17 yr). The male to female ratio was 1:1. Almost all patients, except two, had cervical lymph node swelling. The size of the involved lymph node was less than 4 cm in the greatest dimension in 75% of the patients. All the children had fever as the chief complaint and the mean duration of the fever was 17.7 +/- 11.2 days (range: 2-122 days). Approximately 87% of the patients had leukopenia (WBC < 4000/mm(3)) and 43.8% of the patients had a mild increase in the transaminases on liver function testing. A total of 8 out of the 16 patients were initially misdiagnosed as an infectious disease and treated with antibiotics which caused prolonged hospitalization for most patients. Six patients were treated with prednisone and the prolonged fever subsided immediately after steroid therapy. KFD should be considered in the differential diagnosis of prolonged fever in children with cervical lymphadenopathy. Early cervical lymph node biopsy is necessary to minimize inappropriate examinations and treatments in such cases.
菊池-藤本病（KFD）是一种以发热、白细胞减少和颈部淋巴结病为特征的亚急性坏死性淋巴结炎。儿科文献中关于KFD临床特征和实验室检查结果的报道较少。在本研究中，我们评估了儿童KFD的特征及转归。1998年1月至2003年12月期间，釜山国立大学医院共对412例有发热和外周淋巴结病的患者进行了研究。在这412例患者中，有16例经淋巴结活检确诊为KFD。我们回顾病历，对其临床、实验室检查及转归进行了分析。患者的平均年龄为10.6±3.4岁（范围：4 - 17岁）。男女比例为1:1。除2例患者外，几乎所有患者均有颈部淋巴结肿大。75%的患者受累淋巴结最大径小于4cm。所有儿童均以发热为主诉，发热平均持续时间为17.7±11.2天（范围：2 - 122天）。约87%的患者有白细胞减少（白细胞计数<4000/mm³），43.8%的患者肝功能检查时转氨酶轻度升高。16例患者中有8例最初被误诊为传染病并接受了抗生素治疗，这导致大多数患者住院时间延长。6例患者接受了泼尼松治疗，激素治疗后长期发热立即消退。对于有颈部淋巴结病的儿童长期发热进行鉴别诊断时应考虑KFD。早期进行颈部淋巴结活检对于尽量减少此类病例中不适当的检查和治疗是必要的。
