Kikuchi Disease Treatment & Management

Updated: Sep 25, 2018
  • Author: John Boone, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Treatment

Medical Care

Treatment of Kikuchi disease is generally supportive. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to alleviate lymph node tenderness and fever. The use of corticosteroids, such as prednisone, has been recommended in severe extranodal or generalized Kikuchi disease. [29, 36] Clinical and related laboratory indications for corticosteroid use include the following:

  • Neurologic involvement – Aseptic meningitis, cerebellar ataxia
  • Hepatic involvement – Elevated lactate dehydrogenase (LDH) level
  • Severe lupuslike syndrome – Positive antinuclear antibody (ANA) titers

Jang and colleagues recommended expanding the indications for corticosteroid use to less-severe disease. [36] They administered prednisone when patients had prolonged fever and annoying symptoms lasting more than 2 weeks despite NSAID therapy, as well as for recurrent disease and for patients who desired a faster return to work.

In steroid-resistant and recurrent Kikuchi disease, case reports have described successful use of hydroxychloroquine and intravenous immunoglobulin. [1, 12, 37]