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.^{[30, 38]}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.^[38]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.^{[2, 13, 39]}

Medication

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Author

John Boone, MD Consulting Staff, Department of Otolaryngology, Naval Hospital Oak Harbor

John Boone, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Charles S Kuzma, MD Consulting Staff, Clinical Research Coordinator, First Health of the Carolinas Cancer Center

Charles S Kuzma, MD is a member of the following medical societies: American College of Physicians, American Society of Hematology, California Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Lawrence H Brent, MD Associate Professor of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University; Chair, Program Director, Department of Medicine, Division of Rheumatology, Albert Einstein Medical Center

Lawrence H Brent, MD is a member of the following medical societies: American Association for the Advancement of Science, American Association of Immunologists, American College of Physicians, American College of Rheumatology

Disclosure: Stock ownership for: Johnson & Johnson.

Chief Editor

Sara J Grethlein, MD, FACP Professor of Clinical Medicine, Indiana University School of Medicine; Medical Director of Cancer Services, Indiana University Health, Adult Academic Health Center, IU Simon Cancer and IU North Hospital, Joe and Shelly Schwarz Cancer Center

Sara J Grethlein, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physician Executives, American College of Physicians, American Medical Women's Association, American Society of Clinical Oncology, American Society of Hematology, Gold Humanism Honor Society, Leukemia and Lymphoma Society

Disclosure: Nothing to disclose.

Additional Contributors

Karen Seiter, MD Professor, Department of Internal Medicine, Division of Oncology/Hematology, New York Medical College

Karen Seiter, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, American Society of Hematology

Disclosure: Received honoraria from Novartis for speaking and teaching; Received consulting fee from Novartis for speaking and teaching; Received honoraria from Celgene for speaking and teaching.

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