Kikuchi disease overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Kikuchi's disease (histiocytic necrotizing lymphadenitis) is a rare, non-cancerous enlargement of the lymph nodes: the diagnosis can be confirmed by lymph node biopsy.

Historical Perspective

Kikuchi-Fujimoto disease (KFD) was described in 1972 in Japan by Dr Masahiro Kikuchi in 1972[1] and independently by Y. Fujimoto.

Causes

The cause for Kikuchi disease has not been established although infectious and autoimmune etiologies have been proposed.

Diagnosis

Laboratory Findings

Kikuchi disease is diagnosed by lymph node excisional biopsy. ANA, APLA, anti-dsDNA, RF are usually negative, and may help in differentiating from SLE. Laboratory findings may sometimes include positive results for IgM, IgG or IgA antibodies.

Treatment

Medical Therapy

There is no specific cure for Kikuchi disease. Treatment is largely supportive. NSAIDs are useful if patient presents with tender lymph nodes and fever. Symptomatic measures aimed at relieving the distressing local and systemic complaints have been described as the main line of management of Kikuchi disease. Analgesics, antipyretics, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids have been used. Corticosteroids are useful in severe extranodal or generalized disease. Multiple flares of bulky cervical lymphadenopathy and fever are treated with a low-dose corticosteroid.

References

  1. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes. Acta Hematol Jpn 1972;35:379–80.

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