Clinical outcome and predictive factors of recurrence among patients with Kikuchi's disease

Int J Infect Dis. 2009 May;13(3):322-6. doi: 10.1016/j.ijid.2008.06.022. Epub 2009 Feb 8.

Abstract

Objectives: To evaluate the clinical outcome and predictive factors of recurrence among patients with Kikuchi's disease.

Methods: Between January 2001 and December 2006, all patients with Kikuchi's disease were included in the study. Data were collected on co-morbidities, clinical manifestations, and ultrasound/laboratory findings, and the differences were compared between recurrent disease and non-recurrent disease groups.

Results: The study included 102 patients with a mean age of 26.7 years. Among these patients, three developed systemic lupus erythematosus during the follow-up period, while two cases were later associated with tuberculosis. Eight patients (7.8%) experienced early relapse and 13 (12.7%) showed late recurrence. Patients with recurrent episodes were more likely to have fever and fatigue with extranodal involvement. Compared to the non-recurrent cases, recurrent cases remained symptomatic for a rather longer duration. The positive rate of the fluorescence anti-nuclear antibody (FANA) test was significantly higher in the recurrent disease group compared to the non-recurrent disease group.

Conclusions: Kikuchi's disease took a self-limiting clinical course in most cases, but the recurrence rate found in the present study was higher than that of previous reports. Kikuchi's disease might be a phenotype of diverse disease entities. The prognosis is different according to the underlying cause. The FANA test would be useful in predicting recurrence.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Antinuclear
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / diagnosis
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Histiocytic Necrotizing Lymphadenitis / complications*
  • Histiocytic Necrotizing Lymphadenitis / pathology*
  • Humans
  • Male
  • Recurrence
  • Remission, Spontaneous
  • Tuberculosis / complications*
  • Young Adult

Substances

  • Antibodies, Antinuclear