Clinical manifestations of Kikuchi's disease in southern Taiwan

Hsin-Liang Yu¹*, Susan Shin-Jung Lee¹, Hung-Chin Tsai¹, Chun-Kai Huang¹, Yao-Shen Chen¹, Hsi-Hsin Lin¹, Shue-Ren Wann¹, Yung-Ching Liu¹, Hui-Hwa Tseng^2
1Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung; and ²Department of Pathology, National Yang-Ming University, Taipei, Taiwan
*Current affiliation: Department of Internal Medicine, Kaohsiung Municipal Min Seng Hospital, Kaohsiung, Taiwan

Received: March 22, 2004 Revised: June 21, 2004 Accepted: June 30, 2004

Corresponding author: Dr. Yung-Ching Liu, Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung First Road, Kaohsiung 813, Taiwan. E-mail:

Histiocytic necrotizing lymphadenitis, or Kikuchi's disease (KD), is a self-limiting cervical lymphadenitis of unknown origin. The diagnosis of KD is problematic due to the lack of specific laboratory tests. This study reviewed the clinical characteristics of 58 patients with KD. Clinical manifestations were of considerable diversity. The mean age of patients was 24.88 7.44 years and there was a female predominance (1.76:1). The most frequent clinical findings were enlarged tender lymph nodes (50%), fever (43%), sore throat (21%), non-productive cough (12%), headache (10%), chills (9%) and rhinorrhea (9%). The most common initial laboratory abnormalities were leucopenia (29%), elevated erythrocyte sedimentation rate (14%), liver function impairment (14%), elevated C-reactive protein level (12%), and anemia (10%). Most patients had unilateral lymph node involvement (79%), which was usually located in the posterior triangle of the cervical lymph nodes (90%). Most patients had no comorbid disease (93%). No recurrence occurred. KD should be included in the differential diagnosis of fever with cervical lymphadenopathy.

Key words: Apoptosis, differential diagnosis, histiocytic necrotizing lymphadenitis, Kikuchi's disease, signs and symptoms

J Microbiol Immunol Infect 2005;38:35-40.