Questionable role of human herpesviruses in the pathogenesis of Kikuchi disease

Arch Pathol Lab Med. 2007 Apr;131(4):604-9. doi: 10.5858/2007-131-604-QROHHI.

Abstract

Context: Kikuchi disease is a self-limiting febrile lymphadenopathy characterized by a patchy area of apoptosis. Kikuchi disease is thought to be caused by a virus, but this has not been clearly demonstrated. Human herpesviruses 6 and 7 (HHV-6 and HHV-7) are lymphotropic viruses that can induce apoptosis in infected lymphocytes. Recently, HHV-8 was reported to be a possible etiologic agent of Kikuchi disease.

Objective: To investigate the incidence of HHV-6, HHV-7, and HHV-8 infection in patients with Kikuchi disease.

Design: Seventy archival tissue specimens (from 50 Kikuchi disease cases and 20 control cases) were tested for the presence of HHV-6 and HHV-7 using a nested polymerase chain reaction, and for the presence of HHV-8 using single-step polymerase chain reaction. Immunohistochemistry for HHV-8 expression was carried out in those cases in which HHV-8 was detected using polymerase chain reaction.

Results: Of the 50 cases with Kikuchi disease, 21 (42%) were HHV-6 positive and 32 (64%) were HHV-7 positive. Eight (40%) of the 20 control cases were HHV-6 positive and 9 (45%) were HHV-7 positive. Both HHV-6 and HHV-7 were detected in 15 (30%) of the cases with Kikuchi disease and in 3 (15%) of the control cases. Three (6%) of the 50 cases of Kikuchi disease were HHV-8 positive but revealed no positive cells on immunohistochemical analysis for HHV-8. Human herpesvirus 8 was not expressed in any of the control cases.

Conclusions: There was no association between the presence of HHV-6 or HHV-7 and Kikuchi disease. Because the HHV-8 genome but not protein was detected in a small proportion of the cases of Kikuchi disease, its potential causative role in this disease should be determined by further studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Herpesviridae Infections / complications*
  • Herpesviridae Infections / epidemiology*
  • Herpesvirus 6, Human / isolation & purification
  • Herpesvirus 7, Human / isolation & purification
  • Herpesvirus 8, Human / isolation & purification
  • Histiocytic Necrotizing Lymphadenitis / virology*
  • Humans
  • Immunohistochemistry
  • Incidence
  • Male
  • Middle Aged
  • Polymerase Chain Reaction