Liu Bing, Sun Yi, Hu Bing, Shi Wen-Yuan, Chen Tian-Ming, Liu Lin-Lin, Liu Gang
Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, National Center for Children's Infectious and Allergic Diseases Surveillance, Beijing Research Center for Respiratory Infectious Diseases, Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Key Laboratory of Major Diseases in Children, Ministry of Education, No. 56 Nan Lishi Road, Beijing, 100045, China.
Department of Interventional Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.
BMC Pediatr. 2025 Apr 12;25(1):287. doi: 10.1186/s12887-025-05648-y.
This study was performed to summarize the clinical and laboratory features of children with Kikuchi-Fujimoto disease concurrent with aseptic meningitis or encephalitis.
A case-control study of children diagnosed with Kikuchi-Fujimoto disease at Beijing Children's Hospital from January 2015 to December 2023 was conducted to determine the characteristics of the disease when concurrent with aseptic meningitis or encephalitis.
Our cohort of 64 cases of Kikuchi-Fujimoto disease included 16 children with central nervous system involvement and 48 controls. Among the 16 affected children, the male: female ratio was 1.7:1.0. The age at onset ranged from 3 to 13 years, with a median age of 8 years. All 16 cases had fever, 15 had cervical lymph node tenderness, 11 had headache, and 14 showed decreased white blood cell counts in routine blood tests. Imaging of the head revealed abnormalities in 11 cases, specifically leukoencephalopathy with mostly bilateral involvement. Cervical lymph node tenderness, headache, confusion, convulsions, and elevated C-reactive protein were significantly associated with Kikuchi-Fujimoto disease concurrent with aseptic meningitis or encephalitis (p < 0.05). There was also a significant difference in lactate dehydrogenase levels between children with and without central nervous system involvement (575.8 ± 221.3 vs. 440.0 ± 163.1 U/L, p = 0.014).
For children with Kikuchi-Fujimoto disease, careful evaluation for central nervous system involvement is warranted when cervical lymph node tenderness, elevated C-reactive protein, or elevated lactate dehydrogenase is present. In children presenting with aseptic meningitis or encephalitis, Kikuchi-Fujimoto disease should be considered as a differential diagnosis.
Not applicable.
本研究旨在总结伴发无菌性脑膜炎或脑炎的菊池-藤本病患儿的临床及实验室特征。
对2015年1月至2023年12月在北京儿童医院诊断为菊池-藤本病的患儿进行病例对照研究，以确定该病伴发无菌性脑膜炎或脑炎时的特征。
我们的64例菊池-藤本病队列包括16例有中枢神经系统受累的患儿和48例对照。在16例受累患儿中，男女比例为1.7:1.0。发病年龄为3至13岁，中位年龄为8岁。16例患儿均有发热，15例有颈部淋巴结压痛，11例有头痛，14例血常规显示白细胞计数减少。头颅影像学检查11例有异常，具体为白质脑病，多为双侧受累。颈部淋巴结压痛、头痛、意识模糊、惊厥及C反应蛋白升高与伴发无菌性脑膜炎或脑炎的菊池-藤本病显著相关（p<0.05）。有中枢神经系统受累和无中枢神经系统受累的患儿乳酸脱氢酶水平也有显著差异（575.8±221.3 vs. 440.0±163.1 U/L，p=0.014）。
对于菊池-藤本病患儿，当出现颈部淋巴结压痛、C反应蛋白升高或乳酸脱氢酶升高时，有必要仔细评估中枢神经系统受累情况。对于表现为无菌性脑膜炎或脑炎的患儿，应考虑菊池-藤本病作为鉴别诊断。
不适用。
