{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:33:31Z","timestamp":1791282811856,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Kikuchi\u2010Fujimoto disease (KFD) is a rare disease that typically manifests with fever and cervical lymphadenopathy. Little is known about the risk factors associated with recurrence and their correlation with clinicopathologic features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We analysed 112 patients with KFD, predominantly female (61\/112, 54.5%), with an average age of 29.4\u2009years. The incidence was higher in males up to the age of 20 and higher in females from their 30s onwards. Of the 70 patients with follow\u2010up data, 23% experienced recurrence. Recurrence was associated with lower C4 levels (<jats:italic>P<\/jats:italic>\u2009=\u20090.038) and higher antinuclear antibody (ANA) rates (<jats:italic>P<\/jats:italic>\u2009=\u20090.007) compared to transient disease. The mean duration of symptoms was 71.5\u2009days. Lymph node histology in 98 cases (excluding 14 needle biopsy specimens) was classified into three patterns: proliferative (<jats:italic>n<\/jats:italic>\u2009=\u200975, 77%), necrotizing (<jats:italic>n<\/jats:italic>\u2009=\u200922, 22%), and xanthomatous (<jats:italic>n<\/jats:italic>\u2009=\u20091, 1%). The necrotizing pattern associated with significantly enlarged lymph nodes (<jats:italic>P<\/jats:italic>\u2009=\u20090.047) and a longer symptom duration (<jats:italic>P<\/jats:italic>\u2009=\u20090.009) than the proliferating pattern. The number of CD4\u2010positive lymphocytes was significantly lower in the necrotizing type than in the proliferative type (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results indicated that low C4 levels and positive ANA were associated with KFD recurrence. Although the aetiology of KFD remains elusive, given that some cases develop autoimmune disease, the results suggest that patients with recurrent KFD represent an intermediate status between those with transient KFD and those with overt autoimmune disease. The comprehensive clinicopathological findings of this study may be useful for elucidating its pathogenesis and predicting the clinical course.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.15427","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T01:32:22Z","timestamp":1739842342000},"page":"68-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Kikuchi\u2010Fujimoto disease: investigating comprehensive clinicopathological features and risk factors for recurrence"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8433-4870","authenticated-orcid":false,"given":"Midori Filiz","family":"Nishimura","sequence":"first","affiliation":[{"name":"Department of Molecular Hematopathology Okayama University Graduate School of Health Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikako","family":"Sakao","sequence":"additional","affiliation":[{"name":"Department of Molecular Hematopathology Okayama University Graduate School of Health Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Kurokawa","sequence":"additional","affiliation":[{"name":"Department of Molecular Hematopathology Okayama University Graduate School of Health Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-7501","authenticated-orcid":false,"given":"Yoshito","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of General Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama Japan"},{"name":"Division of Hematology and Oncology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1485-0527","authenticated-orcid":false,"given":"Asami","family":"Nishikori","sequence":"additional","affiliation":[{"name":"Department of Molecular Hematopathology Okayama University Graduate School of Health Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9148-6445","authenticated-orcid":false,"given":"Hidetaka","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Pathology and Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5234-6861","authenticated-orcid":false,"given":"Yasuharu","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Molecular Hematopathology Okayama University Graduate School of Health Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"920","article-title":"Cervical subacute necrotizing lymphadenitis. A new clinicopathological entity","volume":"30","author":"Fujioto YKY","year":"1972","journal-title":"Naika (Intern. Med.)"},{"key":"e_1_2_11_3_1","first-page":"379","article-title":"Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytosis","volume":"35","author":"Kikuchi M","year":"1972","journal-title":"Nippon Ketsueki Gakkai Zasshi"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1309\/YF081L4TKYWVYVPQ"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-006-0230-5"},{"key":"e_1_2_11_6_1","volume-title":"WHO classification of Haematolymphoid Tumours editorial board WHO classification of Haematolymphoid Tumours, 5th ed,","author":"Tumour\u2010like lesions with T\u2010cell predominance","year":"2024"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2008.07.019"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3928\/19382359-20190920-01"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.745506"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.14628"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-1-18"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.5858\/134.2.289"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.12.064"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2006.00505.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-014-2306-6"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S378790"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199507000-00008"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00429352"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0924"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-013-2131-3"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0485"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-009-0194-y"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2009.24.6.1105"},{"key":"e_1_2_11_24_1","first-page":"219","article-title":"Kikuchi\u2010Fujimoto disease in children: clinical features and disease course","volume":"37","author":"Wang TJ","year":"2004","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.01.011"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1684-1182(10)60058-8"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2008.06.022"},{"key":"e_1_2_11_28_1","article-title":"Systemic lupus erythematosus lymphadenopathy presenting as Kikuchi\u2010Fujimoto disease in an adolescent","volume":"15","author":"Harrison J","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcreu.2017.07.006"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-021-00992-7"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-013-1516-z"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.3960\/jslrt.55.127"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.15427","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T23:49:13Z","timestamp":1748908153000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.15427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,17]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/his.15427"],"URL":"https:\/\/doi.org\/10.1111\/his.15427","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,17]]},"assertion":[{"value":"2024-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}