{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:01:58Z","timestamp":1785132118685,"version":"3.55.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The diagnosis of Kikuchi\u2013Fujimoto disease (KFD) is challenging, which is mainly based on typical histopathological findings from a lymph node biopsy. We aimed to develop and validate a predictive model for the diagnosis of KFD based on cytokine profiles and other laboratory findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study included pediatric patients with KFD and controls with other febrile diseases in a retrospective training cohort (\n                      <jats:italic>n<\/jats:italic>\n                      = 673) and a prospective validation cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0116). Clinical data, laboratory parameters, and serum cytokines were collected. Variables with\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05 in univariate analysis and acceptable collinearity were entered into multivariable logistic regression with stepwise selection. A nomogram was constructed based on the final model. Model performance was evaluated using ROC analysis, calibration curves, Hosmer\u2013Lemeshow test, Brier score, and decision curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The final model included age, WBC, neutrophil, hemoglobin, platelets, ESR, IL-10, and IFN-\u03b3\/IL-6, with IFN-\u03b3\/IL-6 modeled as a 4-knot restricted cubic spline. The derived nomogram showed excellent performance in the training cohort (AUC\u00a0=\u00a00.989, sensitivity 97.5%, specificity 94.4%) and maintained robust discrimination in the external validation cohort (AUC\u00a0=\u00a00.971, sensitivity 94.1%, specificity 93.9%). Calibration was good in both cohorts (Hosmer\u2013Lemeshow\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.99 and 0.19, external calibration slope 0.88), with low Brier scores (0.025 and 0.060). The model achieved high predictive accuracy, with 0.966 (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u00a0=\u00a00.836) in the training cohort and 0.931 (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u00a0=\u00a00.831) in the external cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study proposes the first validated diagnostic model for KFD, demonstrating excellent performance and highlighting the IFN-\u03b3\/IL-6 ratio as a key predictor. With further validation, it may serve as a practical decision-support tool to guide clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1701510","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:41:37Z","timestamp":1785130897000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a cytokine-based diagnostic model for Kikuchi\u2013Fujimoto disease"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaona","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Shenzhen Children\u2019s Hospital Affiliated to Shenzhen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science, University of 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Shenzhen Children\u2019s Hospital Affiliated to Shenzhen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingyan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Shenzhen Children\u2019s Hospital Affiliated to Shenzhen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v11.i16.3664","article-title":"Kikuchi-Fujimoto disease: a comprehensive review","volume":"11","author":"Mahajan","year":"2023","journal-title":"World J Clin 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