DNA typing of HLA class II genes (HLA‐DR, ‐DQ and ‐DP) in Japanese patients with histiocytic necrotizing lymphadenitis (Kikuchi’s disease)

Abstract

The pathogenesis of histiocytic necrotizing lymphadenitis (HNL), which was reported first by Kikuchi et al. and Fujimoto et al. in 1972, is as yet unknown. HNL is frequently reported in Asian countries including Japan, however it is rare in Europe and North America. To elucidate whether the human leukocyte antigen (HLA) alleles and haplotypes are associated with HNL, we performed DNA typing of HLA class II genes (HLA-DR, -DQ, and -DP) in 86 patients with HNL and 525 unrelated healthy Japanese controls with polymerase chain reaction using sequence-specific oligonucleotide probes (PCR-SSOP). In this study, we found DPA1*01 and DPB1*0202 allele frequencies in HLA class II genes are significantly higher in HNL patients than in normal controls. It is known that the frequency of DPB1*0202 alleles is extremely low or absent in Caucasians (e.g., French 0.4%, Italian 0.8%) and Negroid (e.g., South African 0%, Hottentot 0%), but relatively frequent in Asians (e.g., Korean 9.9%, Japanese 4.5%). Previous reports have said the incidence of HNL is frequent in Asians but rare in other races. In light of this background, HLA class II genes of HNL and the incidence of HNL in Asian countries, including Japan, might have a positive relationship to DPA1*01 and DPB1*0202 allele.

Kikuchi-Fujimoto Disease With Prolonged Fever in Children

“…[11][12][13][14]16 KFD is more prevalent in Asians, particularly in Far East nations including Korea. [5][6][7][8][9][10] Tanaka et al 9 reported that 2 HLA class II Cervical lymphadenopathy and fever are the most common presentations of the disorder. However, the clinical presentation may vary from patient to patient.…”

“…Although lymphadenopathy usually affects the cervical lymph nodes, the axillary lymph nodes and lymph nodes in other regions can be affected. [3][4][5][6][7][8][9][10]14,19 The size of the affected lymph nodes usually are 2 to 3 cm, but sometimes these nodes can be Ͼ5 cm. An affected lymph node is solid, movable, and painful but not suppurative.…”

“…This disease has now been recognized in many other countries and has also been referred to as Kikuchi's disease, histiocytic necrotizing lymphadenitis, focal histiocytic lymphadenitis, and subacute necrotizing lymphadenitis. [3][4][5][6][7][8][9][10] The characteristic clinical presentation of the disorder includes cervical lymphadenopathy and prolonged fever. Its natural course is usually benign, and the clinical symptoms and signs disappear within a few months without specific treatment.…”

Evaluation of 44 Kikuchi-Fujimoto Disease Cases Reported from Turkey Between 2000-2010 with Pooled Analysis Method

“…9,16 Genetik predispozisyon ve çevresel faktörlerin rolü ise tam olarak aydınlatılamamış olmakla birlikte, Tanaka ve ark., KFH'de HLA sınıf II genlerinin DNA tiplendirmesini çalışmışlar ve hastalığın DPA1*01 ve DPB1*0202 alelleri ile ilişkili olabileceğini belirtmişlerdir. 46 Ülkemizden bildirilen olgular etiyolojik açıdan irdelendiğinde ise sadece beş (%11,4) olguda aktif enfeksiyon (Salmonella paratyphi B, Salmonella typhi, EBV, toksoplazmoz, E. histolytica) tablosunun ve bir hastada Sjögren sendromunun hastalığa eşlik ettiği görülmüştür. Sonuç olarak hastalığın özgül bir etiyolojiden kaynaklanmadığı, çeşitli enfeksiyöz, kimyasal, otoimmün, fiziksel ve neoplastik olayların neden olduğu hiperimmün bir reaksiyon olduğu düşüncesi benimsenmiştir.…”

An unusual cause of cervical lymphadenopathy: Kikuchi-Fujimoto disease

“…8 It commonly affects young population with a peak age of incidence occurring in the third decade, but rarely affects patients under 16 years of age. 9 Early reports suggest affected female cases are more common; however more recently this view has changed to one of equal prevalence in both genders, but both of our cases were female and they were 29 and 22 years old, respectively.…”