儿童菊池-藤本病复发的临床特征及危险因素：一项病例对照研究。
Clinical characteristics and risk factors for recurrence of Kikuchi-Fujimoto disease in children: a case-control study.
作者信息
Liu Bing, Sun Yi, Shi Wen-Yuan, Hu Bing, Guo Ling-Yun, Chen Tian-Ming, Ge Xiao-Ming, Wu Yun-Yan, Liu Gang
机构信息
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, Beijing, 100045, China.
Department of Interventional Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
出版信息
BMC Pediatr. 2025 Jul 2;25(1):485. doi: 10.1186/s12887-025-05831-1.
BACKGROUND
This study was performed to summarize the clinical and laboratory features of children with Kikuchi-Fujimoto disease (KFD). The risk factors of KFD recurrence were analyzed.
METHODS
A retrospective case-control study was conducted on children who underwent lymph node biopsy in the department of infectious diseases of Beijing Children's Hospital from April 2018 to April 2022. The clinical manifestations and treatment of children with KFD were summarized, and the clinical characteristics of children with KFD and the control group were compared. The clinical characteristics of FANA (fluorescent antinuclear antibody) positive group and FANA negative group in children with KFD were compared. The children with KFD were divided into recurrence group and non-recurrence group, and the risk factors for recurrence of KFD were analyzed.
RESULTS
A total of 359 children with lymph node biopsy were included in the study, including 239 children with KFD. The ratio of male to female was 1.85:1 and the average age was (9.78 ± 2.91) years. Two hundred and thirty-five (98.3%) KFD children had fever and two hundred and thirty-six cases (98.7%) of KFD children had cervical lymph node enlargement. A total of 208 (87.0%) KFD children had a decrease in white blood cell count during the course of the disease. The proportions of lymph node enlargement with tenderness, oral ulcer and leucopenia in the KFD group were significantly higher than those in the control group (P < 0.05). The proportion of multiple lymph node involvement in the KFD group was significantly lower than that in the control group (P < 0.05). Among the 239 cases, 51 cases (21.3%) were treated with corticosteroid and 10 received intravenous immunoglobulin therapy. Among the 239 patients with KFD, 30 (12.6%) had recurrence and 12 of them had recurrence within 3 months after discharge. In univariate analysis, recurrence was associated with positive antinuclear antibody and corticosteroid therapy (P < 0.05).No risk factor for recurrence was identified in multivariable analysis (P > 0.05).
CONCLUSIONS
KFD in children is more common in males and mostly occurs at school age. KFD in children is characterized by tenderness in the lymph node and leukopenia with less multiple lymph node involvement. All patients should be monitored for recurrence.
背景
本研究旨在总结儿童菊池-藤本病（KFD）的临床和实验室特征，并分析KFD复发的危险因素。
方法
对2018年4月至2022年4月在北京儿童医院感染科接受淋巴结活检的儿童进行回顾性病例对照研究。总结KFD患儿的临床表现及治疗情况，并比较KFD患儿与对照组的临床特征。比较KFD患儿中荧光抗核抗体（FANA）阳性组和FANA阴性组的临床特征。将KFD患儿分为复发组和非复发组，分析KFD复发的危险因素。
结果
本研究共纳入359例接受淋巴结活检的儿童，其中KFD患儿239例。男女比例为1.85:1，平均年龄为（9.78±2.91）岁。235例（98.3%）KFD患儿有发热，236例（98.7%）KFD患儿有颈部淋巴结肿大。共有208例（87.0%）KFD患儿在病程中白细胞计数下降。KFD组淋巴结肿大伴压痛、口腔溃疡和白细胞减少的比例显著高于对照组（P<0.05）。KFD组多个淋巴结受累的比例显著低于对照组（P<0.05）。239例中，51例（21.3%）接受了糖皮质激素治疗，10例接受了静脉注射免疫球蛋白治疗。239例KFD患者中，30例（12.6%）复发，其中12例在出院后3个月内复发。单因素分析显示，复发与抗核抗体阳性及糖皮质激素治疗有关（P<0.05）。多因素分析未发现复发的危险因素（P>0.05）。
结论
儿童KFD男性更为常见，多发生于学龄期。儿童KFD的特点是淋巴结压痛、白细胞减少，多个淋巴结受累较少。所有患者均应监测复发情况。
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