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Shengfang Bao, Hua Huang, Yingying Jin, Fei Ding, Zhen Yang, Xuemei Xu, Chenxi Liu, Xiqiong Han, Liping Wang, Jingyi Lu, Jiani Ma, Yanliang Jin Department of Rheumatology & Immunology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People’s Republic of ChinaCorrespondence: Yanliang Jin, Email jinyanliang@scmc.com.cnAbstract: Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, and self-limiting condition characterized by lymph node inflammation. While KFD is rarely associated with ocular manifestations, our case report highlights bilateral optic neuritis in a 13-year-old male patient with KFD. We also provide a comprehensive review of similar cases in the literature.Keywords: Kikuchi-Fujimoto disease, optic neuritis, neuromyelitis optica spectrum disorder, vision deficiency

Shengfang Bao,1,&ast; Jingyi Lu,1,&ast; Hua Huang,1 Ying-Ying Jin,1 Fei Ding,1 Zhen Yang,1 Xuemei Xu,1 Chenxi Liu,1 Xi Mo,2 Yanliang Jin1 1Department of Rheumatology & Immunology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xi Mo; Yanliang Jin, Email xi.mo@shsmu.edu.cn; jinyanliang@scmc.com.cnObjective: To evaluate the risk of major infections in children with newly diagnosed childhood-onset systemic lupus erythematosus (cSLE).Methods: Predictors of major infections were identified by the multivariable logistic regression. Major infection free was defined as no major infection events within 6 months after the diagnosis of cSLE. The Kaplan–Meier survival plot was performed. A prediction model for major infection events was established and examined by receiver operating characteristic (ROC) curve analysis.Results: A total of 98 eligible patients were recorded in the medical charts. Sixty-three documented events of major infections were found in 60 (61.2%) cSLE patients. Furthermore, 90.5% (57/63) of infection events occurred within the first 6 months after the diagnosis of cSLE. The high SLEDAI (SLEDAI > 10), lupus nephritis and lymphocyte count < 0.8× 109/L were predictors for major infections. The CALL score (Children with high disease activity [SLEDAI > 10], lymphopenia, and LN) was defined by the number of predictors. Patients were then categorized into two groups: low-risk (score 0– 1) and high-risk (score 2– 3). Patients in the high-risk group had higher rates of the major infection occurrence than those in the low-risk group during the 6 months after the diagnosis of the cSLE (P< 0.001) (HR:14.10, 95% CI 8.43