菊地氏病

Kikuchi-Fujimoto Disease

李瑞文(Jui-Wen Lee) ； 袁本治(Ben-Chih Yuan) ； 林振東(Chen-Tung Lin) ； 錢尚道(Shang-Tao Chien)

《台灣耳鼻喉頭頸外科雜誌》 45卷1期 (2010/02) Pp. 7-12

https://doi.org/10.6286/2010.45.1.7

摘要

背景：菊地氏病為良性、自限性疾病，常見於亞洲人，歐美少見，顯示東西方人種在菊地氏病有一定程度的差異性。本研究蒐集台灣南部某區域醫院確定診斷菊地氏病病例，加以分析討論，並比較東西方菊地氏病病人的差異。
方法：從2001年1月至2008年1月，以回溯病歷方式，收集病理報告為菊地氏病，計32個病例。回溯其臨床記錄，分析性別、年齡、症狀等記錄，並以門診追蹤及電話訪問追蹤，追蹤時間為4個月至7年，中位數為3年6個月。
結果：男女比為1：1.46，平均年齡為25歲，症狀以單側、多發、壓痛性、後頸部三角區的頸部腫塊最為常見，實驗室檢查以白血球低下、肝功能異常、貧血較常見，大部分病人頸部腫塊在6個月內緩解，無復發或死亡案例。
結論：本研究病例的年齡、症狀、理學檢查、實驗室數據與歐美無太大差異，惟男女得病比(1:1.46)比起歐美國家(1:4)差異較小。診斷以病理報告為主，以鎮痛解熱劑及低劑量類固醇治療，6個月內會使頸部腫塊緩解。在台灣地區，對於年輕病人出現發燒併有單側後頸部三角區壓痛性腫塊，要特別考慮菊地氏病的可能性。

關鍵字

菊地氏病 ； 組織球壞死性淋巴結炎

並列摘要

BACKGROUND: Kikuchi's disease is a benign, self-limiting disease that is relatively common in Asia but is uncommon in Europe and America. This situation illustrates to some extent the differences between Eastern and Western countries. This study collected cases of individuals with Kikuchi’s disease that presented at a regional hospital in southern Taiwan. The aim of this study was an analysis and discussion of the differences in cases of Kikuchi's disease between the Eastern and Western countries.
METHOD: We retroactively reviewed 32 cases of Kikuchi's disease diagnosed by pathological tests that presented at a regional hospital in southern Taiwan between January 2001 to January 2008. After review of the medical records of the 32 cases, the gender, age and symptoms of the patients were analyzed. The patients had been followed up for between four months and seven years by outpatient visits and using telephone tracking.
RESULTS: The male to female ratio was 1:1.46 and the average age was 25 years old. The most common symptom was the presence of multiple unilateral post cervical masses with tenderness. The common laboratory findings were leukopenia, impairment liver function and anemia. The cervical masses usually resolved within six months in most cases. There were no cases where recurrence occurred and/or the disease was fatal.
CONCLUSION: There were no significant differences in age, symptoms, physical examination results or laboratory findings between the cases in this Taiwanese study and the cases in Europe and America. However, the ratio between males and females in Taiwan was lower than that found in Europe and America. Further studies are needed to investigate whether race is a risk factor for Kikuchi's disease. Diagnosis of Kikuchi's disease is mainly based on the pathological findings identified on presentation, while using involves the prescription of a non-steroid anti-inflmmation drug together with a low dosage steroid. In these circumstances, most cervical masses have improved by the end of six months. Kikuchi's disease should be considered as a possible differential diagnosis among young people in Taiwan who have fever and unilateral posterior cervical masses with tenderness.

並列關鍵字

Kikuchi-Fujimoto Disease ； histiocytic necrotizing lymphadenitis