From: Various aspects of Kikuchi disease in three children: systemic or self-limited disease?
Patient 1 | Patient 2 | Patient 3 | |
---|---|---|---|
Age (years) | 5 | 17 | 9 |
Underlying disease | Non complicated sickle cell anemia | Severe sickle cell anemia | None |
Symptoms | - Left cervical lymphadenopathy - Intermittent fever | - Intermittent fever - Maculo-papules - Fatigue - Painful cervical and inguinal adenopathies - Headaches - Polyarthritis | - Prolonged fever - Intermittent tonsillitis - Bilateral painful cervical lymph nodes |
Biological features | - Mild inflammation - Elevated LDH | - Marked inflammation - Pancytopenia - Auto-immune anemia - Auto-immune hepatitis - No ANA | - Marked inflammation - Leucopenia |
Biopsy | Cervical lymph node excisional biopsy | Cervical lymph node excisional biopsy | Tonsillectomy |
Treatment | None | - Steroids for 7 months - Azathioprine - Methotrexate | None |
Outcome | Spontaneous resolution after 4 months | Progressive regression of clinical and biological signs with resolution of auto-immunity | Spontaneous resolution 2 months after tonsillectomy |