Kikuchi-Fujimoto Disease: A Case with Persistent Lymphadenopathy and Fever, Easily Misdiagnosed as Bacterial Lymphadenitis

菊地氏病：有持續性淋巴結腫大和發燒病例，誤診為細菌性淋巴結炎

10.3966/168232812015092503005

周國燊(Kuo-Shen Chow)；吳建林(Mark Chien-Lin Wu)

頸部淋巴腫大 ； 菊地氏病 ； cervical lymphadenopathy ； Kikuchi-Fujimoto disease

台灣家庭醫學雜誌

25卷3期（2015 / 09 / 01）

208 - 216

英文

菊地氏病（Kikuchi-Fujimoto disease）是一種良性、自癒性疾病，主要影響20－30歲的年輕人，以女性佔大多數。菊地氏病也影響兒童，但關於兒童患者的罹病比例並無太多相關研究資料。菊地氏病病因尚不明確，發病機轉可能與自體免疫系統有關，已知菊地氏病的患者有較高的比例會罹患全身性紅斑狼瘡。頸部淋巴病變是最突出、也最常見的徵兆，應與淋巴組織增生疾病、自體免疫疾病和感染疾病做病理組織學上的區分。我們提出一位14歲女孩，有持續性淋巴結腫大和發燒，起初被診斷為細菌性淋巴結炎（bacterial lymphadenitis），病理學報告出來之後，診斷被更正為菊地氏病。我們將提供有關菊地氏病的簡要回顧，並強調在臨床上顯著淋巴結腫大、臨床治療效果未如預期時，應及時為患者做組織病理學檢查，以做出準確的診斷。

Kikuchi-Fujimoto disease (KFD) is a benign and self-limited disease. It mostly affects young adults in their 20-30 years of age and is female predominant. KFD also affects children but the overall population of pediatric patients has not yet been defined in the literature. Its etiology is unclear and a role of the autoimmune system in the pathogenesis is hypothesized. KFD is well known for its association with systemic lupus erythematosus (SLE). Cervical lymphadenopathy is the most prominent and encountered sign and should be histopathologically differentiated from lymphoproliferative, autoimmune, and infectious diseases. We report a 14 years old girl with persistent cervical lymphadenopathy and fever, diagnosed initially with bacterial lymphadenitis and later corrected as KFD after histopathological report. We herein provide a brief review about KFD and emphasize on the importance of prompt histopathological examination for patients presented with clinically significant lymphadenopathy and unfavorable clinical features in order to make timely accurate diagnosis.

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