Kikuchi disease is a rare condition that mainly affects people of Asian descent, causing enlarged lymph nodes in the neck and shoulders. It usually resolves on its own, but can be mistaken for more serious conditions. Treatment varies, with some doctors prescribing NSAIDs or fever reducers, while others suggest intravenous immunoglobulin for more resistant cases. Regular checkups are recommended after recovery due to a possible link between Kikuchi disease and the development of lupus.
Kikuchi disease or Kikuchi-Fujimoto disease (KFD) is a rare condition that tends to appear in the Asian population and occurs more often in people of Japanese descent. It has occasionally occurred in other ethnic groups, but its greatest tendency is to occur in those with Asian ancestry. It is usually a condition that resolves on its own, within a few months of the initial expression, but its symptoms make it somewhat complex. In particular, KFD presents with very enlarged lymph nodes in the neck and shoulders, and these can be mistaken for extremely serious conditions such as lupus or lymphoma. Because treatment varies widely and KFD usually resolves on its own, it is often advisable to rule out Kikuchi disease through biopsy of a swollen node, although less often done in very low-risk populations.
In addition to swollen lymph nodes in the neck, which can grow several inches, some people with Kikuchi disease may have other symptoms. Many people have a fever which may increase during the night. Others report additional problems such as stomach upset (vomiting, nausea). This can lead to weight loss. Another symptom sometimes associated with KFD is severe sore throat, but this is not always present.
When an appropriate diagnosis is made, treatment can still be variable. Some doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or higher prescription drugs only to treat the discomfort associated with swollen lymph nodes. Ironically, in high doses these drugs can increase stomach pain. Other preferred treatments include fever reducers and pain relievers such as acetaminophen. Continuing research in this area has suggested that several drugs that could be used instead include intravenous immunoglobulin, which could treat more resistant cases.
Even without pharmacological intervention, most people get better. Very rarely, Kikuchi’s disease can cause lung or liver complications, and these require additional surgery so they don’t cause mortality. It is best to see a doctor if you suspect this disease or whenever the lymph nodes in this area become very swollen.
There is much discussion about the origins of Kikuchi’s disease and current thinking in the medical field tends to consider this condition as a complication or the result of other viruses. Several candidate viruses are suggested including Epstein-Barr or HIV. Exactly how these viruses create disease is not always clearly understood. Some specialists view the disease as a short-lived autoimmune condition from which the body recovers.
One of the recommendations for people with Kikuchi disease is to have regular checkups for several years after recovery. The reason for this recommendation is controversial and subject to debate. There may be a link between the onset of KFD and the subsequent development of lupus. The link is by no means clear or proven in all cases, but common sense would suggest having medical help from time to time in the years following KFD to get lupus treated early if it occurs.
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