Cheng Ran, Lin Fei, Lu Ming
Department of Infectious Diseases, Peking University Third Hospital, Beijing, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People's Republic of China.
J Inflamm Res. 2024 Nov 21;17:9319-9324. doi: 10.2147/JIR.S480056. eCollection 2024.
Kikuchi-Fujimoto disease (KFD) is self-limiting, has an unknown origin, and predominantly affects the lymph nodes. KFD with aseptic meningitis is rare and diagnostically challenging. This retrospective observational study aimed to elucidate the clinical features and treatment outcomes of KFD, particularly in cases with aseptic meningitis.
We conducted this retrospective study to describe KFD to determine the characteristics of the disease, with a particular focus on cases involving aseptic meningitis.
Our study comprised 103 patients (33 men, 70 women) diagnosed with KFD at Peking University Third Hospital between January 2013 and March 2024. Diagnosis was based on histological examination of lymph node biopsies. The mean age was 25 (range: 16-66) years. Clinical manifestations included fever (100%), cervical pain (79.6%), fatigue (49.5%), headache (44.7%), myalgia (26.2%), and hepatosplenomegaly (23.3%). Biological signs included leukopenia (66.0%) and elevated lactate dehydrogenase (>250 U/L, 83.5%) and ferritin (>300 ng/mL, 44.6%) levels. Forty-three cases improved with nonsteroidal anti-inflammatory drugs (NSAIDs) as monotherapy, whereas 24 required corticosteroid therapy. Four of the 46 patients with headache underwent cerebrospinal fluid analysis, confirming aseptic meningitis. Notably, all four responded well to nonsteroidal anti-inflammatory drugs.
Our findings highlight the features and outcomes of KFD, particularly its association with aseptic meningitis, which has a favorable prognosis in the absence of corticosteroid therapy.
菊池-藤本病（KFD）是一种自限性疾病，病因不明，主要累及淋巴结。合并无菌性脑膜炎的KFD较为罕见，诊断具有挑战性。这项回顾性观察研究旨在阐明KFD的临床特征和治疗结果，尤其是无菌性脑膜炎病例。
我们进行这项回顾性研究以描述KFD，确定该疾病的特征，特别关注涉及无菌性脑膜炎的病例。
我们的研究纳入了2013年1月至2024年3月期间在北京大学第三医院诊断为KFD的103例患者（33例男性，70例女性）。诊断基于淋巴结活检的组织学检查。平均年龄为25岁（范围：16 - 66岁）。临床表现包括发热（100%）、颈部疼痛（79.6%）、疲劳（49.5%）、头痛（44.7%）、肌痛（26.2%）和肝脾肿大（23.3%）。生物学指标包括白细胞减少（66.0%）以及乳酸脱氢酶升高（>250 U/L，83.5%）和铁蛋白升高（>300 ng/mL，44.6%）。43例患者使用非甾体类抗炎药（NSAIDs）单药治疗后病情改善，而24例需要使用糖皮质激素治疗。46例头痛患者中有4例进行了脑脊液分析，确诊为无菌性脑膜炎。值得注意的是，所有4例对非甾体类抗炎药反应良好。
我们的研究结果突出了KFD的特征和结果，尤其是其与无菌性脑膜炎的关联，在不使用糖皮质激素治疗的情况下预后良好。
