Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
J Pediatr. 2023 Sep;260:113515. doi: 10.1016/j.jpeds.2023.113515. Epub 2023 May 25.
To outline the characteristics of Kikuchi-Fujimoto disease (KFD) in children and analyze factors associated with severe and recurring courses.
Electronic medical records of children histopathologically diagnosed with KFD at Seoul National University Bundang Hospital from March 2015 to April 2021 were retrospectively reviewed.
A total of 114 cases (62 males) were identified. The mean patient age was 12.0 ± 3.5 years. Most patients came to medical attention with cervical lymph node enlargement (97.4%) and fever (85%); 62% had a high-grade fever (≥39°C). Prolonged fever (≥14 days) was seen in 44.3% and was associated with a high-grade fever (P = .004). Splenomegaly, oral ulcer, or rash was present in 10.5%, 9.6%, and 15.8%, respectively. Laboratory findings showed leukopenia, anemia, and thrombocytopenia in 74.1%, 49%, and 24%, respectively. Sixty percent of cases had a self-limited course. Antibiotics were initially prescribed in 20%. A corticosteroid was prescribed in 40% of patients and was associated with oral ulcer (P = .045) and anemia (P = .025). Twelve patients (10.5%) had a recurrence with a median interval of 19 months. No risk factor for recurrence was identified in multivariable analysis. Clinical characteristics of KFD were similar between our current and previous studies. However, antibiotics use decreased (P < .001); nonsteroidal anti-inflammatory drugs use increased (P < .001), and, although statistically not significant, corticosteroid treatment also increased.
Over a span of 18 years, the clinical characteristics of KFD did not change. Patients presenting with high-grade fever, oral ulcer, or anemia may benefit from corticosteroid intervention. All patients should be monitored for recurrence.
概述儿童期 Fujimoto 病（KFD）的特征，并分析与严重和复发性病程相关的因素。
回顾性分析 2015 年 3 月至 2021 年 4 月在首尔国立大学盆唐医院接受组织病理学诊断为 KFD 的儿童的电子病历。
共确定 114 例（62 例男性）。患者的平均年龄为 12.0±3.5 岁。大多数患者因颈部淋巴结肿大（97.4%）和发热（85%）就诊；62%有高热（≥39°C）。44.3%的患者出现发热时间延长（≥14 天），与高热相关（P=0.004）。脾肿大、口腔溃疡或皮疹分别为 10.5%、9.6%和 15.8%。实验室检查发现白细胞减少、贫血和血小板减少分别占 74.1%、49%和 24%。60%的病例为自限性病程。最初开了 20%的抗生素。40%的患者开了皮质类固醇，与口腔溃疡（P=0.045）和贫血（P=0.025）相关。12 例（10.5%）患者复发，中位间隔为 19 个月。多变量分析未发现复发的危险因素。我们当前和之前的研究中，KFD 的临床特征相似。然而，抗生素的使用减少了（P<0.001）；非甾体抗炎药的使用增加了（P<0.001），虽然统计学上没有意义，但皮质类固醇的治疗也增加了。
在 18 年的时间里，KFD 的临床特征没有改变。出现高热、口腔溃疡或贫血的患者可能受益于皮质类固醇干预。所有患者均应监测复发情况。
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