Subject(s)
Histiocytic Necrotizing Lymphadenitis/diagnosis , Tuberculosis, Lymph Node/diagnosis , Child , Diagnosis, Differential , Histiocytic Necrotizing Lymphadenitis/epidemiology , Histiocytic Necrotizing Lymphadenitis/pathology , Humans , Male , Peru/epidemiology , Tuberculosis, Lymph Node/pathologyABSTRACT
OBJECTIVE: To provide an epidemiologic description of Kikuchi-Fujimoto disease (KFD), and to describe its relationship with systemic lupus erythematosus (SLE) in a population of sub-Saharan origin. METHODS: Patients were retrospectively included on the basis of lymph node histology compatible with KFD reported in Martinique from 1991 until 2013. In order to describe the characteristics of the disease in a larger cohort, we subsequently included more patients of Afro-Caribbean origin from Guadeloupe and French Guiana. RESULTS: In Martinique, mean annual incidence between 1991 and 2013 was 2.78 cases for 1 million inhabitants (95% confidence interval 1.73-3.93). A total of 36 Afro-Caribbean patients from the 3 French American regions were included. Mean age was 30.5 years (range 5-59 years) and the female:male ratio was 3:1. The main characteristics were cervical adenopathies (88.8%), fever (83.3%), asthenia (73.0%), weight loss (64.4%), and recurrence in 33.3%. KFD was associated with lupus (n = 9 for SLE, n = 2 for cutaneous lupus) in 36.6% (11 of 30). CONCLUSION: We report the first epidemiologic description of KFD in a population of sub-Saharan origin. According to our data, this disease is present in the black African diaspora and is strongly associated with autoimmune diseases, particularly lupus.
Subject(s)
Black People/statistics & numerical data , Histiocytic Necrotizing Lymphadenitis/epidemiology , Adolescent , Adult , Child , Child, Preschool , Female , France/ethnology , Histiocytic Necrotizing Lymphadenitis/ethnology , Histiocytic Necrotizing Lymphadenitis/etiology , Humans , Incidence , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/ethnology , Male , Martinique/epidemiology , Middle Aged , Retrospective Studies , Young AdultABSTRACT
OBJECTIVES: To analyze the clinical characteristics of children with Kikuchi-Fujimoto disease focusing on cases with prolonged fever. STUDY DESIGN: This was a retrospective study of children diagnosed with Kikuchi-Fujimoto disease from March 2003 to February 2015 in South Korea. Electronic medical records were searched for clinical and laboratory manifestations. RESULTS: Among 86 histopathologically confirmed cases, the mean age was 13.2 (SD ± 3.1) years, and male to female ratio was 1:1.32. Cervical lymph node enlargement, found in 85 of the patients (99%), was predominantly unilateral in 64 (75%), and involved the cervical lymph node level V in 67 (81%). Fever was present in 76% of the cases, with a median duration of 9 days (IQR 0.25-17.0). Multivariate analysis revealed that a high fever peak ≥ 39.0°C (P = .010) and presentation with ≥ 2 systemic symptoms other than fever (P = .027) were factors that were significantly associated with longer fever duration. As the size of the largest lymph node's short diameter increased, the fever duration increased (P = .015). Leukopenia (P = .022) also had a significant association with a longer fever duration. Patients with sonographic findings of conglomerated enlarged lymph nodes had a longer median duration of fever compared with those with separate enlarged lymph nodes (11 vs 4.5 days, P = .019). CONCLUSIONS: Patients with high fever, more systemic symptoms, leukopenia, and larger lymph nodes with a conglomerated distribution may benefit from early recognition and selective consideration of corticosteroid therapy.
Subject(s)
Histiocytic Necrotizing Lymphadenitis/diagnosis , Histiocytic Necrotizing Lymphadenitis/epidemiology , Adolescent , Adrenal Cortex Hormones/therapeutic use , Anti-Bacterial Agents/therapeutic use , Child , Electronic Health Records , Female , Fever/complications , Humans , Leukopenia/complications , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Male , Multivariate Analysis , Prednisone/administration & dosage , Recurrence , Republic of Korea , Retrospective Studies , Seasons , Time Factors , Treatment Outcome , UltrasonographyABSTRACT
La enfermedad de Kikuchi o Kikuchi Fujimoto o linfadenitis histiocítica necrotizante, es una rara y habitualmente benigna enfermedad que se presenta con fiebre y adenopatías cervicales usualmente en mujeres jóvenes. La etiología es desconocida, aunque hay evidencias de su origen viral y la semejanza del grupo poblacional afectado con el lupus eritematoso sistémico ha alentado, en base a estudios celulares, la sospecha de que el síndrome de Kikuchi refleja una condición Lupus - símil auto limitada y causada por linfocitos transformados por una infección viral. Inicialmente descripta en Japón, la enfermedad de Kikuchi Fujimoto se ha reportado en diferentes grupos étnicos y raciales, aunque ha sido predominantemente descripto en Asia. La enfermedad puede ser sospechada por la clínica pero se necesita de la anatomía patológica para su confirmación.(AU)
Subject(s)
Humans , Female , Histiocytic Necrotizing Lymphadenitis/diagnosis , Histiocytic Necrotizing Lymphadenitis/etiology , Histiocytic Necrotizing Lymphadenitis/complications , Histiocytic Necrotizing Lymphadenitis/epidemiology , Histiocytic Necrotizing Lymphadenitis/immunology , Histiocytic Necrotizing Lymphadenitis/physiopathology , Histiocytic Necrotizing Lymphadenitis/therapy , Diagnosis, Differential , AdolescentABSTRACT
La enfermedad de Kikuchi o Kikuchi Fujimoto o linfadenitis histiocítica necrotizante, es una rara y habitualmente benigna enfermedad que se presenta con fiebre y adenopatías cervicales usualmente en mujeres jóvenes. La etiología es desconocida, aunque hay evidencias de su origen viral y la semejanza del grupo poblacional afectado con el lupus eritematoso sistémico ha alentado, en base a estudios celulares, la sospecha de que el síndrome de Kikuchi refleja una condición Lupus - símil auto limitada y causada por linfocitos transformados por una infección viral. Inicialmente descripta en Japón, la enfermedad de Kikuchi Fujimoto se ha reportado en diferentes grupos étnicos y raciales, aunque ha sido predominantemente descripto en Asia. La enfermedad puede ser sospechada por la clínica pero se necesita de la anatomía patológica para su confirmación.