All issues > Volume 49(8); 2006

Original Article

Korean J Pediatr. 2006;49(8):875-881. Published online August 15, 2006.

Histiocytic necrotizing lymphadenitis in children : association of human herpes virus 8 and Epstein Barr virus

Hyun A HA Kim¹, Ju-Young JY Chung¹, Sang Woo SW Kim¹, Sung Jig SJ Lim², Haeng Seop HS Shin³

¹Departments of Pediatrics, College of Medicine, Inje University, Seoul, Korea
²Departments of Pathology, College of Medicine, Inje University, Seoul, Korea
³Division of AIDS, National Institute for Health, Seoul, Korea

Correspondence Ju-Young JY Chung ,Email: pedchung@sanggyepaik.ac.kr

Abstract

Purpose
: The aims of this study were to analyze the clinical characteristics of children with Kikuchi's disease(KD) at a medical center and to investigate the etiologic role of human herpesvirus 8(HHV 8) or Epstein-Barr virus(EBV) in children with KD.
Methods
: Twenty six children who were diagnosed as KD between Jan. 1998 and Dec. 2005 were included. Medical records were reviewed on the clinical characteristics of children with KD. Follow up data were collected by chart review and telephone contact. Polymerase chain reaction(PCR) was performed in order to detect HHV 8 DNA, and in situ hybridization(ISH) was perfomed in order to detect EBV RNA from 20 lymph node tissues.
Results
: There were 15 girls and 11 boys with a mean age of 13 years. Posterior cervical lymph nodes were involved in 72 percent(18/25) of the patients. Extracervical lymphadenopathy was associated in one patient. Fever was an associated symptom in 31 percent(8/26) of the patients. Leukopenia was observed in six (46 percent) patients. The cervical lymphadenopathy usually resolved spontaneously within 6 months. Only one patient had a recurrence of lymphadenopathy with fever during follow-up. No children with KD in our series developed systemic lupus erythematosus. HHV 8 DNA was not amplified by nested PCR in any of the cases, and all cases were negative for EBV RNA by ISH.
Conclusion
: KD should be differentiated as a cause of cervical lymphadenopathy in children. HHV 8 and EBV may not play major causative roles in KD in children.

Keywords :Histiocytic necrotizing lymphadenitis , Child, Herpesvirus 8 , Human , Epstein-Barr virus