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Volume 43, Number 5, October 2010

Clinical Presentations, Laboratory Results and Outcomes of Patients with Kikuchi’s Disease: Emphasis on the Association Between Recurrent Kikuchi’s Disease and Autoimmune Diseases

Chien-Yu Cheng, Wang-Huei Sheng, Yi-Chun Lo, Chen-Shuan Chung, Yee-Chun Chen, Shan-Chwen Chang

Received: February 25, 2009    Revised: June 30, 2009    Accepted: August 20, 2009   


Corresponding author:

Shan-Chwen Chang, Division of Infectious Diseases, Department of Internal Medicine, National Taiwan
University Hospital, 7 Chung Shan South Road, Taipei, Taiwan.


Background and purpose: 

Kikuchi’s disease (KD), also known as histiocytic necrotizing lymphadenitis, is a benign and self-limiting disease of unknown etiology that mainly affects young women. There is limited data on the long-term prognosis of patients with KD.



We describe the clinical manifestations and outcomes of 195 patients, diagnosed as having KD at National Taiwan University Hospital from March 1989 to September 2006.



All together, 53.3% of our patients presented with tender lymphadenopathy, 37.9% with fever and 16.9% with headache. The most common laboratory findings were elevated erythrocyte sedimentation rate (78.9%), elevated serum lactate dehydrogenase (52.5%), elevated C-reactive protein (38.3%), monocytosis (26.9%), elevated serum alanine aminotransferase (23.3%) and leukopenia (18.9%). A total of 183 patients followed a benign course, with spontaneous resolution of fever and lymphadenopathy. However, 14 patients (14.6%) with follow-up of more than 6 months had clinical recurrence of KD; hence, long-term follow-up is suggested. Five of these patients developed an autoimmune disease, namely, systemic lupus erythematosus (n = 2), Graves’ disease (n = 2), or mixed connective tissue disease (n = 1). One patient with recurrent KD died of intracranial hemorrhage due to thrombocytopenia.



The prognosis for KD patients is generally optimistic; however, a concurrent autoimmune
disease or the risk of developing an autoimmune disease requires careful monitoring.


Key words:

autoimmune disease, histiocytic necrotizing lymphadenitis, Kikuchi’s diseas