Various aspects of Kikuchi disease in three children: systemic or self-limited disease?

Kikuchi’s disease (KD), or histiocytic necrotizing lymphadenitis, is a rare benign and self-limited disease involving young adults, predominantly females. It is rarely described in children. It is characterized by localized lymphadenopathy, often associated with fever and systemic symptoms. The diagnosis is based on histological examination of lymph node biopsy. The disease usually resolves spontaneously over a period of several weeks to months. In some cases, KD reveals or evolves into a systemic lupus, reason why long term follow-up is recommended.

Three cases of pediatric KD are presented in Table 1.

Table 1

In conclusion, KD is rarely observed in children, has various presentations but usually favorable outcome. This small cohort of pediatric patients illustrates this diversity: one of them presented with marked systemic symptoms, suggesting SLE but resolving after prolonged corticotherapy, while the others had a more benign course with spontaneous resolution after excision. Association with sickle cell disease has not been described and, to our best knowledge, this is the first case diagnosed on tonsil examination.