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Anini EM, AlBaik TM, Ibrahim AT, AbuKaresh NA, Albandak M, Alshalaldeh R, Natsheh M, Abunejma FM. Kikuchi-Fujimoto Disease: A Case Report of Prolonged Fever and Lymphadenopathy in a Young Girl. J Investig Med High Impact Case Rep 2024; 12:23247096241246618. [PMID: 38605558 PMCID: PMC11010749 DOI: 10.1177/23247096241246618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/13/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a benign and self-limited disorder that usually presents with regional cervical lymphadenopathy and fever. We report a case of a 12-year-old female who complained of fever, night sweating, significant weight loss, and tender right cervical lymph node enlargement for 2 months. A full workup including laboratory tests and imaging studies, an excisional biopsy, and histopathological analysis were done, and the diagnosis of KFD was confirmed. The patient was treated with analgesia and oral prednisolone, resulting in good improvement. A high degree of clinical suspicion is imperative for physicians, given the rarity of the disease and the associated diagnostic challenges.
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Yousefi M, Rukerd MRZ, Binafar H, Shoaie S, Mirkamali H, Pourzand P, Kaveh R. The co-occurrence of Kikuchi-Fujimoto disease and systemic lupus erythematosus: a case report. J Med Case Rep 2023; 17:448. [PMID: 37884991 PMCID: PMC10605312 DOI: 10.1186/s13256-023-04186-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Kikuchi-Fujimoto disease is an uncommon systemic disease that mostly affects young women. Kikuchi-Fujimoto disease typically manifests as necrotizing lymphadenopathy, which frequently follows by a fever; however, Kikuchi-Fujimoto disease occurs rarely in extranodal regions. One of the most important accompaniments of Kikuchi-Fujimoto disease is its connection with autoimmune diseases such as systemic lupus erythematosus. This case presents a simultaneous occurrence of Kikuchi-Fujimoto disease with liver involvement and systemic lupus erythematosus in a young female patient. CASE PRESENTATION We present a rare case of a 20-year-old white woman who presented with fever, joint pains, myalgia, and shortness of breath. Initial hospitalization and treatment for fever of unknown origin did not yield improvement. Physical examination revealed cervical and supraclavicular lymphadenopathy, and laboratory investigations showed abnormal blood counts, elevated inflammatory markers, and positive autoimmune serologies. Imaging studies revealed bilateral pleural effusion and liver lesions. Lymph node biopsy confirmed the diagnosis of Kikuchi-Fujimoto disease, and liver biopsy showed extranodal involvement. The patient was diagnosed with Kikuchi-Fujimoto disease-associated systemic lupus erythematosus and treated with hydroxychloroquine and corticosteroids. The patient showed gradual resolution of symptoms and lymphadenopathy with treatment. CONCLUSION Kikuchi-Fujimoto disease is a rare systemic condition primarily impacting young females. It is characterized by necrotizing lymphadenopathy, often accompanied by fever. Although Kikuchi-Fujimoto disease is predominantly seen in the lymph nodes, occurrences in non-nodal areas are infrequent. When diagnosing Kikuchi-Fujimoto disease, it is essential to screen patients for systemic lupus erythematosus. In this particular case, we observed liver involvement along with the presence of both Kikuchi-Fujimoto disease and systemic lupus erythematosus.
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Affiliation(s)
- Maysam Yousefi
- Infectious Diseases Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Rezaei Zadeh Rukerd
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Hanieh Binafar
- Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Sahar Shoaie
- Department of Internal Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Hanieh Mirkamali
- Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Pouria Pourzand
- Department of Emergency Medicine, School of Medicine, University of Medicine, Minneapolis, USA
| | - Roxana Kaveh
- Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Decker ME, Griffith M, Ahmed A, Madu P, Skopis PK. A rare acneiform eruption presentation of Kikuchi-Fujimoto disease presenting with concurrent systemic lupus erythematosus. JAAD Case Rep 2023; 40:112-114. [PMID: 37766732 PMCID: PMC10520494 DOI: 10.1016/j.jdcr.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- Morgan E. Decker
- Department of Dermatology, Rush University Medical Center, Chicago, Illinois
| | | | - Aadil Ahmed
- Illinois Dermatology Institute, Chicago, Illinois
| | - Pamela Madu
- Department of Dermatology, Rush University Medical Center, Chicago, Illinois
| | - Penelope K. Skopis
- Department of Dermatology, Rush University Medical Center, Chicago, Illinois
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Liu J, Zheng Q, Shi L, Zhao Z, Chen X, Wang T, Chen X. A retrospective study of 134 patients with cervical region Kikuchi-Fujimoto disease. Laryngoscope Investig Otolaryngol 2023; 8:865-869. [PMID: 37621285 PMCID: PMC10446312 DOI: 10.1002/lio2.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/04/2023] [Accepted: 05/23/2023] [Indexed: 08/26/2023] Open
Abstract
Background To explore the clinical and laboratory features, therapy and prognosis of Kikuchi-Fujimoto disease (KFD) in the cervical region. Methods We retrospectively reviewed the medical records of 134 patients who were diagnosed and treated with KFD from January 2000 to May 2022 in Fujian Medical University Union Hospital (Fujian, China). Their clinical characteristics, affected lymph node size, imaging examinations, and laboratory study results were analyzed. Results The mean patient age was 24.9 years, and the male-female ratio was 1:1.73. Fever (55.2%, n = 74) was the most common clinical manifestation. Leukopenia (49.3%) was the commonest reported laboratory abnormality. A majority (65.7%) of the 134 patients presented with bilateral nodal involvement. Conclusion KFD should be considered as a possible diagnosis in a female patient under the age of 30 presenting with cervical lymphadenopathy, fever, leukopenia, and elevated LDH. Level of Evidence 4.
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Affiliation(s)
- Jianzhi Liu
- Department of OtolaryngologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Qiaoling Zheng
- Department of PathologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Liangwen Shi
- Department of OtolaryngologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Zhiwei Zhao
- Department of OtolaryngologyZhangzhou Affiliated Hospital of Fujian Medical UniversityZhangzhouFujianChina
| | - Xuxiang Chen
- Department of OtolaryngologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Taiqin Wang
- Department of OtolaryngologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Xiaoqiang Chen
- Department of OtolaryngologyFujian Medical University Union HospitalFuzhouFujianChina
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Arya P V A, Alam MM, Bernhisel A, Degirolamo A, Huang R. Diagnostic Dilemma in a Case of Necrotizing Lymphadenitis With Macrophage Activation Syndrome. Cureus 2023; 15:e42267. [PMID: 37605695 PMCID: PMC10440125 DOI: 10.7759/cureus.42267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 08/23/2023] Open
Abstract
Necrotizing lymphadenitis is a histological diagnosis that can arise from various conditions, including lupus lymphadenitis (LL), Kikuchi disease (KD), and infectious causes. Distinguishing between Kikuchi disease and lupus lymphadenitis can be challenging in clinical practice. In this report, we present the clinical scenario of a young female patient with lymphadenopathy and elucidate the process through which we ultimately arrived at a diagnosis of systemic lupus erythematosus (SLE) with macrophage activation syndrome. This case underscores the significance of recognizing Kikuchi disease as a condition that can mimic lupus and sheds light on the distinguishing features of necrotizing lymphadenitis, with a particular focus on Kikuchi disease and lupus lymphadenitis.
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Affiliation(s)
| | - Md Mashiul Alam
- Cardiovascular Disease, Mayo Clinic, Rochester, USA
- Internal Medicine, Bridgeport Hospital, Bridgeport, USA
| | - Andrew Bernhisel
- Pathology, Yale School of Medicine, Yale University, New Haven, USA
| | | | - Rex Huang
- Rheumatology, Yale University, New Haven, USA
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Alshekaili J, Nasr I, Al-Rawahi M, Ansari Z, Al Rahbi N, Al Balushi H, Al Zadjali S, Al Kindi M, Al-Maawali A, Cook MC. A homozygous loss-of-function C1S mutation is associated with Kikuchi-Fujimoto disease. Clin Immunol 2023; 252:109646. [PMID: 37209807 DOI: 10.1016/j.clim.2023.109646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Kikuchi-Fujimoto disease (KFD) is a self-limited inflammatory disease of unknown pathogenesis. Familial cases have been described and defects in classical complement components C1q and C4 have been identified in some patients. MATERIAL AND METHODS We describe genetic and immune investigations of a 16 years old Omani male, a product of consanguineous marriage, who presented with typical clinical and histological features of KFD. RESULTS We identified a novel homozygous single base deletion in C1S (c.330del; p. Phe110LeufsTer23) resulting in a defect in the classical complement pathway. The patient was negative for all serological markers of SLE. In contrast, two female siblings (also homozygous for the C1S mutation), one has autoimmune thyroid disease (Hashimoto thyroiditis) and a positive ANA and the other sibling has serology consistent with SLE. CONCLUSION We report the first association between C1s deficiency and KFD.
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Affiliation(s)
- Jalila Alshekaili
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
| | - Iman Nasr
- Department of Adult Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | - Mohammed Al-Rawahi
- Department of Hematology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Zainab Ansari
- Department of Adult Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman
| | | | - Hamed Al Balushi
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Shoaib Al Zadjali
- Department of Hematology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Mahmood Al Kindi
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Almundher Al-Maawali
- Genetics Department, Sultan QaboosUniversity Hospital, Sultan Qaboos University, Muscat, Oman
| | - Matthew C Cook
- Department of Immunology and Infectious Disease, John Curtin School of Medical Research, Australian National University, Canberra, NSW, Australia; Department of Medicine, University of Cambridge, United Kingdom; Centre for Personalised Immunology, John Curtin School of Medical Research, Australian National University, Canberra, NSW, Australia.
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Mallick A, Mohapatra MM, Babu VM, Rajaram M, Gocchait D, Surendranath Warrier L. All necrotizing nodes are not tuberculosis - A report of two cases. Indian J Tuberc 2022; 69:695-698. [PMID: 36460410 DOI: 10.1016/j.ijtb.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/04/2021] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Kikuchi-Fujimoto disease is a benign and self-limiting systemic disorder of unknown aetiology characterised by fever, superficial lymphadenopathy and leukopenia. In highly endemic & low-resource country like India, it is frequently misdiagnosed as tuberculosis. CASE REPORT Both the cases were diagnosed as necrotizing lymphadenitis by fine-needle aspiration cytology. Tuberculin skin prick test (TST) was positive for one case and negative for the other case. Cartridge based nucleic acid amplification test (CBNAAT) from lymph node aspirate was negative for mycobacterium tuberculosis in both the cases, later on histopathology of lymph node showed diagnosis of Kikuchi-Fujimoto disease. CONCLUSION Kikuchi Fujimoto is a self-limiting disease systemic disease of unknown aetiology. A definite diagnosis can be established by incisional/excisional biopsy of the lymph node. When dealing with cases of tubercular lymphadenitis, Kikuchi-Fujimoto disease should be kept as differential diagnosis.
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Masiak A, Lass A, Kowalski J, Hajduk A, Zdrojewski Z. Self-limiting COVID-19-associated Kikuchi-Fujimoto disease with heart involvement: case-based review. Rheumatol Int 2022; 42:341-348. [PMID: 35024942 PMCID: PMC8757403 DOI: 10.1007/s00296-021-05088-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/30/2021] [Indexed: 12/17/2022]
Abstract
Background The association between COVID-19 infection and the development of autoimmune diseases is currently unknown, but there are already reports presenting induction of different autoantibodies by SARS-CoV-2 infection. Kikuchi-Fuimoto disease (KFD) as a form of histiocytic necrotizing lymphadenitis of unknown origin. Objective Here we present a rare case of KFD with heart involvement after COVID-19 infection. To our best knowledge only a few cases of COVID-19-associated KFD were published so far. Based on presented case, we summarize the clinical course of KFD and its association with autoimmune diseases, as well we discuss the potential causes of perimyocarditis in this case. Methods We reviewed the literature regarding cases of “Kikuchi-Fujimoto disease (KFD)” and “COVID-19” and then “KFD” and “heart” or “myocarditis” by searching medical journal databases written in English in PubMed and Google Scholar. Results Only two cases of KFD after COVID infection have been described so far. Conclusion SARS-CoV-2 infection can also be a new, potential causative agent of developing KFD.
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Affiliation(s)
- Anna Masiak
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, ul. Dębinki 7, 80-952, Gdańsk, Poland.
| | - Amanda Lass
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, ul. Dębinki 7, 80-952, Gdańsk, Poland
| | - Jacek Kowalski
- Department of Pathomorphology, Medical University of Gdansk, Gdańsk, Poland
| | - Adam Hajduk
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, ul. Dębinki 7, 80-952, Gdańsk, Poland
| | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, ul. Dębinki 7, 80-952, Gdańsk, Poland
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Faria C, Fernandes M, Cunha R, Moreira H, Costa R. Kikuchi-Fujimoto Disease: Diagnosis in a Relapsing Case. Cureus 2021; 13:e19542. [PMID: 34934560 PMCID: PMC8668199 DOI: 10.7759/cureus.19542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/20/2022] Open
Abstract
The differential diagnosis of cervical lymphadenopathy is varied. Different age groups require different approaches. Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a rare but important diagnosis to consider after excluding more common aetiologies. We present the case of a 21-year-old female with painful left cervical swelling, lasting over a week. Physical examination revealed multiple cervical lymphadenopathies, elastic, non-adherent to deep tissues which were tender to touch. Blood tests showed elevated acute phase proteins. Cytomegalovirus, Epstein-Barr, toxoplasmosis, and human immunodeficiency virus serologies were negative. Computed tomography of the neck revealed multiple cervical lymphadenopathies which were round-shaped, some with necrosis and with extracapsular extent. These features could be compatible with tuberculous lymphadenitis. However, interferon-gamma release assay was negative. Excisional biopsy was scheduled, but spontaneous regression did not allow it. Two weeks later she relapsed. Excisional biopsy revealed histiocytic necrotizing lymphadenitis. Kikuchi-Fujimoto’s diagnosis demands high clinical suspicion and histological documentation. This case represents a rare diagnosis of a relapsing disease.
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Affiliation(s)
- Catarina Faria
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, PRT
| | - Marco Fernandes
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, PRT
| | - Rui Cunha
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, PRT
| | - Hugo Moreira
- Internal Medicine Department, Hospital São Francisco Xavier, Lisboa, PRT
| | - Rui Costa
- Internal Medicine, Hospital da Luz, Lisboa, PRT
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Ahmed Z, Quadir H, Hakobyan K, Gaddam M, Kannan A, Ojinnaka U, Mostafa JA. Kikuchi-Fujimoto Disease: A Rare Cause of Cervical Lymphadenopathy. Cureus 2021; 13:e17021. [PMID: 34522502 PMCID: PMC8425500 DOI: 10.7759/cureus.17021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a rare benign disease, clinically characterized by fever and tender cervical lymphadenopathy affecting the posterior cervical lymph nodes. This disease is usually accompanied by night sweats, rashes, and headaches. It generally affects young individuals, especially females, of Oriental-Asian origin. The etiology of KFD remains uncertain, but associations have been noted with viral diseases including Epstein-Barr virus (EBV), herpes simplex virus (HSV), and varicella-zoster virus (VZV), as well as autoimmune disorders including systemic lupus erythematosus (SLE) and Sjogren's syndrome. This review points out the etiology of KFD with cervical lymphadenopathy alongside its clinical presentation, histological highlights, lab investigations, complications, and treatment. Accurate diagnosis of this disease depends on lymph node excisional biopsy. Three histological patterns of KFD are recognized: proliferative, necrotizing, and xanthomatous. Distinction from lymphadenopathy-associated alternate disorders (e.g., SLE, malignancy, tuberculosis, or another infectious lymphadenitis) is essential to ensure appropriate therapy. This self-limited condition entails nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief with consideration of corticosteroids and hydroxychloroquine in severe cases.
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Affiliation(s)
- Zubayer Ahmed
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Huma Quadir
- Internal Medicine/Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Knkush Hakobyan
- Diagnostic Radiology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mrunanjali Gaddam
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Amudhan Kannan
- General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ugochi Ojinnaka
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Jayawickreme KP, Subasinghe S, Weerasinghe S, Perera L, Dissanayaka P. A young girl with chronic isolated cervical lymphadenopathy found to have lupus lymphadenopathy, progressing to develop lupus nephritis: a case report. J Med Case Rep 2021; 15:328. [PMID: 34176492 PMCID: PMC8237432 DOI: 10.1186/s13256-021-02949-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/08/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Systemic lupus erythematosus is a rare autoimmune disorder, with the prevalence in Asia ranging from 30 to 50/100,000. The diagnosis of systemic lupus erythematosus is made according to the 2019 European League Against Rheumatism/American College of Rheumatology classification criteria, and it does not contain lymphadenopathy as diagnostic criteria. However, lupus lymphadenopathy has an estimated prevalence of 5-7% at the onset of disease, and 12-15% at any stage of the disease. CASE PRESENTATION A 19-year-old Sinhalese girl had neck nodules since the age of 5 years, which increased in size and became tender since 1 year. She had alopecia and joint stiffness for 6 months. She presented with a 5-day history of worsening joint pain, fever, and painful, enlarging cervical nodules. She had tender cervical lymphadenopathy, and a vasculitic rash on both lower limbs. She had pancytopenia, an erythrocyte sedimentation rate of 92, positive antinuclear antibody titer, and high anti-double-stranded deoxyribonucleic acid (DNA), with low C3 and C4 complements. She had a high reticulocyte count of 5%, with direct and indirect antiglobulin tests being positive, indicating autoimmune hemolytic anemia. Lymph node biopsy showed moderate reactive follicular hyperplasia, with scattered plasma cells and immunoblasts, with varying degree of coagulative necrosis, suggestive of lupus lymphadenopathy. On immunohistochemistry of the lymph node biopsy, Bcl2 was negative, excluding lymphoma. Contrast-enhanced computed tomography of abdomen and chest was normal with no hepatosplenomegaly or lymphadenopathy. Skin biopsy showed leukocytoclastic vasculitis. Later, with development of generalized edema, she was found to have impaired renal function, and renal biopsy showed lupus nephritis. She was started on hydroxychloroquine, prednisolone, and mycophenolate mofetil, and her symptoms improved and lymphadenopathy regressed. CONCLUSION In the case of cervical lymphadenopathy in a patient with systemic lupus erythematosus, the possibilities of lupus lymphadenopathy, Kikuchi-Fujimoto disease, and lymphoma should all be considered, after excluding secondary infection due to immunosuppression. Histology confirms the differentiation of these pathologies. It is important to differentiate the cause for lymphadenopathy in systemic lupus erythematosus as the outcome and treatment varies. Lupus lymphadenopathy is usually generalized, but isolated cervical lymphadenopathy could also rarely be the first presentation of systemic lupus erythematosus. Lupus lymphadenopathy can be the only presenting feature, and needs a high index in suspecting systemic lupus erythematosus, though it is not included in the diagnostic criteria.
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Affiliation(s)
- K P Jayawickreme
- Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka.
| | - S Subasinghe
- Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka
| | - S Weerasinghe
- Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka
| | - L Perera
- Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka
| | - P Dissanayaka
- Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka
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12
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Sekiguchi S, Yamamoto Y, Hatakeyama S, Matsumura M. Recurrent Aseptic Meningitis Associated with Kikuchi's Disease (Histiocytic Necrotizing Lymphadenitis): A Case Report and Literature Review. Intern Med 2021; 60:1779-1784. [PMID: 33431735 PMCID: PMC8222115 DOI: 10.2169/internalmedicine.6494-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We herein report a 31-year-old man with recurrent aseptic meningitis associated with Kikuchi's disease. Although aseptic meningitis is the most common neurological complication of Kikuchi's disease, its characteristics remain unclear, especially in recurrent cases. A literature review revealed that aseptic meningitis associated with Kikuchi's disease was more likely to occur in men and was associated with a low cerebrospinal fluid (CSF)/serum glucose ratio. Lymphadenopathy tended to occur simultaneously or after the onset of meningitis. When encountering a patient with aseptic meningitis of unknown etiology, it may be worthwhile to focus on the CSF/serum glucose ratio and lymphadenopathy with a careful examination.
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Affiliation(s)
- Shiori Sekiguchi
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Japan
| | - Shuji Hatakeyama
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Japan
| | - Masami Matsumura
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, Japan
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13
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Ghadiri N, Stanford M. Case of vaso-occlusive retinopathy in Kikuchi-Fujimoto and lupus overlap syndrome. BMJ Case Rep 2021; 14:14/5/e240752. [PMID: 34059537 DOI: 10.1136/bcr-2020-240752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 35-year-old woman presented with a constellation of systemic symptoms: rashes, weight loss, arthralgia and mouth ulcers. Six months afterwards, she experienced bilateral and sequential reduction in vision, and was found to have bilateral vaso-occlusive retinopathy, with critical macular ischaemia in the left eye. Her serological markers were consistent with a diagnosis of lupus. A lymph node biopsy confirmed Kikuchi-Fujimoto disease, a benign condition of unknown cause characterised by fever, cervical and axillary lymphadenopathy. Given that this overlap syndrome was associated with a number of systemic features and had affected the eyes, an immunosuppressive regime with rituximab was considered prudent. This rendered her vasculitis stable and non-progressive, and there were signs of partial retinal microvasculature recovery on optical coherence tomography angiography. There is increasing evidence of an overlap between Kikuchi-Fujimoto disease and systemic lupus erythematosus, which is associated with vaso-occlusive retinopathy. In these instances, a multidisciplinary approach is warranted, with consideration of appropriate treatment in order to prevent harmful sequelae of vasculitis. Our treatment with rituximab abated the disease process, although close follow-up is paramount to monitor results and side-effects of treatment.
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Affiliation(s)
- Nima Ghadiri
- Department of Ophthalmology, Medical Eye Unit, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Miles Stanford
- Department of Ophthalmology, Medical Eye Unit, Guy's and St Thomas' Hospitals NHS Trust, London, UK
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14
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Song Y, Liu S, Song L, Chen H, Bai M, Yan J, Luo T, Liu K, Sun L, Zhao Y. Case Report: Histiocytic Necrotizing Lymphadenitis (Kikuchi-Fujimoto Disease) Concurrent With Aseptic Meningitis. Front Neurol 2021; 12:565387. [PMID: 33959084 PMCID: PMC8093430 DOI: 10.3389/fneur.2021.565387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 03/10/2021] [Indexed: 11/17/2022] Open
Abstract
Kikuchi–Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, self-limiting disease characterized by local lymphadenopathy. Central nervous system involvement in KFD is extremely rare and remains a diagnostic challenge. Only 41 cases of aseptic meningitis associated with KFD have been reported worldwide, with just four cases (including our case) of KFD with meningitis as the first symptom. We report a case of KFD accompanied by aseptic meningitis with severely high intracranial pressure (400 mmH2O), increased white blood cell count (56 × 106/L), and moderately elevated protein level (0.52 g/L). This case is unique in the delayed appearance of lymphadenopathy. After 1 month of treatment with steroids, fever, headache, and lymphadenopathy gradually disappeared, and the result of cerebrospinal fluid examination gradually became normal. In conclusion, based on our case findings and our literature review on KFD with aseptic meningitis, a diagnosis of KFD should be considered when delayed appearance of lymphadenopathy is observed in patients with aseptic meningitis.
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Affiliation(s)
- Yanna Song
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Shan Liu
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Lei Song
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Huaqiu Chen
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Miaoshui Bai
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Jinhua Yan
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Tianfei Luo
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Kangding Liu
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Li Sun
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Yang Zhao
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
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15
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Müller CSL, Vogt T, Becker SL. Kikuchi-Fujimoto Disease Triggered by Systemic Lupus Erythematosus and Mycoplasma pneumoniae Infection-A Report of a Case and a Review of the Literature. Am J Dermatopathol 2021; 43:202-208. [PMID: 32809980 DOI: 10.1097/dad.0000000000001764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT Kikuchi-Fujimoto disease (KFD) is a necrotizing histiocytic lymphadenitis that was described for the first time in 1972 in Japan. Its etiology is still not fully understood. It has been reported in association with many different agents, diseases, and triggering factors without any conclusive result. To the best of our knowledge, we report for the first time a case of KFD with systemic lupus erythematosus in a child in association with a polymerase chain reaction (PCR)-positive throat swab for Mycoplasma pneumoniae. Although difficult to prove, the acute M. pneumoniae infection might have served as a triggering event for the development of KFD in our case. We encourage further studies to investigate a potential relationship between KFD and M. pneumoniae, which should also use PCR-based testing for this pathogen in patients with KFD.
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Affiliation(s)
- Cornelia S L Müller
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Thomas Vogt
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg/Saar, Germany
- Swiss Tropical and Public Health Institute, Basel, Switzerland; and
- University of Basel, Basel, Switzerland
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16
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Halawa ARR, Ahmad MK, Nashwan AJ. An atypical presentation of Kikuchi-Fujimoto disease: A case report & literature review. Clin Case Rep 2020; 8:3515-3519. [PMID: 33363963 PMCID: PMC7752579 DOI: 10.1002/ccr3.3373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/01/2020] [Accepted: 08/24/2020] [Indexed: 11/09/2022] Open
Abstract
The authors urge clinicians to consider the possibility of Kikuchi-Fujimoto Disease associated with autoimmune hemolytic anemia with possible correlation with systemic lupus erythematosus in patients presented with lymphadenopathy and fever.
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Affiliation(s)
| | - Muayad K. Ahmad
- Department of MedicineHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
- Weill Cornell Medical College in Qatar (WCM‐Q)DohaQatar
| | - Abdulqadir J. Nashwan
- Hazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
- University of Calgary in Qatar (UCQ)DohaQatar
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17
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Aun JA, Hubbard MJ. Kikuchi-Fujimoto Disease Heralding Systemic Lupus Erythematosus. J Osteopath Med 2020; 120:934-939. [DOI: 10.7556/jaoa.2020.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
In this case report, the authors discuss a patient with a rare entity, Kikuchi Fujimoto Disease, which exhibited unique osteopathic structural examination findings, including enlarged cervical lymph nodes in conjunction with a Chapman reflex (CR). This report highlights the critical importance of histological examination of the lymph nodes. Additionally, it reminds physicians to consider the ways in which CR can potentially contribute to the diagnostic process.
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18
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Jung HJ, Lee IJ, Yoon SH. Risk Assessment of Recurrence and Autoimmune Disorders in Kikuchi Disease. Risk Manag Healthc Policy 2020; 13:1687-1693. [PMID: 33061702 PMCID: PMC7519817 DOI: 10.2147/rmhp.s271283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/27/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Kikuchi disease (KD) is typically a benign disease. Recent studies reporting recurrence or serious cases suggest a possible association of KD with systemic autoimmune disorders. We performed a long-term analysis of the characteristics of KD in patients of all ages and assessed KD recurrence or progress to systemic autoimmune disorders. Patients and Methods Electronic medical records of patients diagnosed with KD between April 1995 and May 2017 were reviewed for clinical and laboratory manifestations. Results In total, 480 patients were confirmed to have KD based on histopathology findings. The mean age at KD diagnosis was 24.4 years. Recurrence occurred in 11.3% of patients; 2.7% developed autoimmune diseases after KD diagnosis. Patients who experienced recurrence had more extranodal symptoms, lymphopenia, and a longer lymphopenia-recovery duration. Patients who developed autoimmune diseases after KD were more likely to have extranodal symptoms, KD recurrence, and anti-nuclear antibody positivity. Conclusion KD patients with risk factors need to be followed-up for KD recurrence and the development of systemic autoimmune diseases.
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Affiliation(s)
- Hyun Joo Jung
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggi-do, South Korea
| | - Il Jae Lee
- Department of Plastic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggi-do, South Korea
| | - Seung-Hyun Yoon
- Department of Physical Medicine and Rehabilitation, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggi-do, South Korea
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19
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Kikuchi-Fujimoto disease associated with primary Sjögren's syndrome - literature review based on a case report. Reumatologia 2020; 58:251-256. [PMID: 32921833 PMCID: PMC7477469 DOI: 10.5114/reum.2020.98438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/04/2020] [Indexed: 12/17/2022] Open
Abstract
Primary Sjögren’s syndrome (pSS) is a chronic, autoimmune disease predominantly involving exocrine glands. Lymphadenopathy is one of the possible symptoms of pSS. It may also suggest development of non-Hodgkin lymphoma (NHL), the most severe complication of pSS, or be a symptom of less common diseases, such as Kikuchi-Fujimoto disease (KFD), presented in this paper. Kikuchi-Fujimoto disease is an extremely rare, benign and self-limiting disorder, characterized by regional lymphadenopathy. This paper presents a case of previously unreported association of pSS, KFD and renal cancer in a patient with recurrent cervical lymphadenopathy, as well as a discussion on the coexistence of these diseases based on available literature searching for PubMed, Scopus and Google Scholar databases, particularly in this subject. These three clinical entities may manifest lymphadenopathy each, causing a diagnostic dilemma. The treatment is also challenging under such circumstances. In this particular situation, it was a combination of immunosuppressive therapy and surgery.
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Kim L, Tatarina-Numlan O, Yin YD, John M, Sundaram R. A Case of Kikuchi-Fujimoto Disease in a 7-Year-Old African American Patient: A Case Report and Review of Literature. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e922784. [PMID: 32830793 PMCID: PMC7476743 DOI: 10.12659/ajcr.922784] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Patient: Female, 7-year-old Final Diagnosis: Kikuchi-Fujimoto lymphadenitis Symptoms: Lymphadenopathy Medication:— Clinical Procedure: Biopsy Specialty: Immunology • Rheumatology
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Affiliation(s)
- Liyoung Kim
- Department of Pediatrics, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Oksana Tatarina-Numlan
- Department of Pediatrics, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Yongmei D Yin
- Department of Pathology and Laboratory Medicine, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Minnie John
- Department of Pediatrics, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Revathy Sundaram
- Department of Pediatrics, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
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21
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Sukswai N, Jung HR, Amr SS, Ng SB, Sheikh SS, Lyapichev K, El Hussein S, Loghavi S, Agbay RLMC, Miranda RN, Medeiros LJ, Khoury JD. Immunopathology of Kikuchi-Fujimoto disease: A reappraisal using novel immunohistochemistry markers. Histopathology 2020; 77:262-274. [PMID: 31854007 DOI: 10.1111/his.14050] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/10/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022]
Abstract
AIMS Kikuchi-Fujimoto disease (KFD) is a self-limited disease characterised by destruction of the lymph node parenchyma. Few studies have assessed the immunohistological features of KFD, and most employed limited antibody panels that lacked many of the novel immunohistochemistry markers currently available. METHODS AND RESULTS We used immunohistochemistry to reappraise the microanatomical distribution of plasmacytoid dendritic cells (pDCs), follicular helper T cells and cytotoxic T cells, B cells, follicular dendritic cell (FDC) meshworks, and histiocytes in lymph nodes involved by KFD. The study group consisted of 138 KFD patients (89 women; 64.5%) with a median age of 27 years (range, 3-50 years). Cervical lymph nodes were most commonly involved, in 108 (78.3%) patients. The numbers of pDCs were increased, predominantly around and within apoptotic areas and the paracortex, and tapering off within xanthomatous areas. pDCs formed sizeable tight clusters, most notably around apoptotic/necrotic areas. T cells consisted mostly of CD8-positive cells with predominant expression of T-cell receptor-β. There were notable increases in the numbers of CD8-positive T cells within lymphoid follicles, and their numbers correlated with alterations in FDC meshworks (P < 0.001). The number of follicular helper T cells was decreased within distorted FDC meshworks. CD21 highlighted frequent distortion of FDC meshworks, even in lymph node tissue that was distant from apoptotic/necrotic areas. Distorted FDC meshworks spanned all morphological patterns, and FDC meshwork characteristics (intact; distorted; remnant/nearly absent) correlated with morphological patterns (P < 0.01). CONCLUSIONS The immunohistological landscape of KFD is complex and characterised by increased numbers of pDCs that frequently cluster around apoptotic/necrotic foci, increased numbers of cytotoxic T cells, and substantial distortion of FDC meshworks.
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Affiliation(s)
- Narittee Sukswai
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
- Department of Pathology, Chulalongkorn University, Bangkok, Thailand
| | - Hye Ra Jung
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
- Department of Pathology, Keimyung University, Dongsan Medical Center, Seoul, South Korea
| | - Samir S Amr
- Department of Pathology, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Siok Bian Ng
- Department of Pathology, National University Hospital, Singapore
| | - Salwa S Sheikh
- Department of Pathology, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Kirill Lyapichev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
| | - Siba El Hussein
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
| | - Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
| | - Rose Lou Marie C Agbay
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
- Department of Pathology, The Medical City Hospital, Manila, Philippines
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TV, USA
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22
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Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis. Case Rep Med 2020; 2020:4385286. [PMID: 31969905 PMCID: PMC6969645 DOI: 10.1155/2020/4385286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/08/2019] [Accepted: 12/19/2019] [Indexed: 11/20/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a rare form of painful lymphadenopathy, usually cervical, which is more common in Southeast Asia and rarely reported from Africa. Symptoms are usually nonspecific (fever, night sweats, etc.), and can mimic more common diseases such as tuberculosis (TB) in endemic areas. We report a case of a 29-year-old black African woman who was admitted with headache, neck pain, fever, and lymphadenopathy. She was found to have aseptic meningitis, eventually attributed to TB based on cervical node biopsy, although further histology suggested KFD. Blood tests for systemic lupus erythematosus (SLE) were negative; she had already been commenced on anti-TB treatment and had responded well and so was continued with this therapy. She was also later diagnosed with Hashimoto's thyroiditis 3 months after her diagnosis of KFD. Five months after stopping TB treatment, she was readmitted with the same symptoms and associated painless lymphadenopathy. Repeat biopsy was morphologically similar to that of 2017, and repeat evaluation confirmed SLE. She has since been managed by a rheumatologist and continues to do well.
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24
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Fernandez-Flores A. La biopsia cutánea en el contexto de la enfermedad sistémica. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:710-727. [DOI: 10.1016/j.ad.2019.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 02/07/2023] Open
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Delplanque M, Chasset F, Hirsch P, Malard F, Ditchi Y, Fain O, Mekinian A. Cutaneous lupus with Kikuchi disease-like inflammatory pattern associated with myelodysplastic syndrome. Rheumatology (Oxford) 2019; 58:554-556. [PMID: 30590766 DOI: 10.1093/rheumatology/key413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2018] [Indexed: 01/08/2023] Open
Affiliation(s)
- Marion Delplanque
- Department of Internal Medicine, APHP, Saint Antoine Hospital, Sorbonne Université, France
| | - François Chasset
- Department of Dermatology, APHP, Tenon Hospital, Sorbonne Université, France
| | - Pierre Hirsch
- Department of Haematology, APHP, Saint Antoine Hospital, Sorbonne Université, France
| | - Florent Malard
- Department of Clinical Haematology, APHP, Saint Antoine Hospital, Sorbonne Université, France
| | - Yoan Ditchi
- Department of Anatopopathology, APHP, Tenon Hospital, Sorbonne Université, France
| | - Olivier Fain
- Department of Internal Medicine, APHP, Saint Antoine Hospital, Sorbonne Université, France
| | - Arsene Mekinian
- Department of Internal Medicine, APHP, Saint Antoine Hospital, Sorbonne Université, France
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26
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Singh JM, Shermetaro CB. Kikuchi-Fujimoto Disease in Michigan: A Rare Case Report and Review of the Literature. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2019; 12:1179550619828680. [PMID: 30833818 PMCID: PMC6393831 DOI: 10.1177/1179550619828680] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/28/2018] [Indexed: 11/16/2022]
Abstract
Background: Kikuchi-Fujimoto Disease (KFD), also known as Histiocytic Necrotizing Lymphadenitis, is a rare cause of prolonged cervical lymphadenopathy in both the pediatric and adult populations. It was first reported in Japan in 1972, and since, this disease has been described worldwide, although most cases have been reported in Asia. The etiology of KFD is not fully understood, although there are 2 theories that are described in detail in this review. Kikuchi-Fujimoto Disease typically follows a benign course, with resolution of the lymphadenopathy within 6 months. It is important to recognize KFD as a cause of persistent lymphadenopathy, as it shares many characteristics with and must be differentiated from other causes of lymphadenopathy, including lymphoma, inflammatory disorders, autoimmune conditions, and infectious causes of lymphadenopathy. Case presentation: Here is presented a case of an 11-year-old male who was born in Vietnam, but subsequently adopted and raised in the United States, who presented to a private practice community-based Otolaryngology group. His chief complaint was a persistent neck mass of approximately 3 months duration. He underwent excisional biopsy for suspected lymphoma, but final pathology rendered a diagnosis of KFD. Conclusion: The purpose of this article is not only to review the literature but also to contribute awareness of this entity in the differential diagnosis of persistent lymphadenopathy, especially for the general Otolaryngologist in a community-based setting. In addition, this review would be beneficial for other practitioners as well, specifically Pediatricians, Infectious Disease Physicians, Rheumatologists, Pathologists, and Medical Oncologists.
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Affiliation(s)
- Jeffrey Michael Singh
- Department of Otolaryngology/Head and Neck Surgery, McLaren Oakland Hospital, Pontiac, MI, USA
- Jeffrey Michael Singh, McLaren Oakland Hospital, 50 North Perry St, Pontiac, IL 48342, USA.
| | - Carl Bernard Shermetaro
- Department of Otolaryngology/Head and Neck Surgery, McLaren Oakland Hospital, Pontiac, MI, USA
- North Oakland Ear, Nose & Throat Centers, P.C., Clarkston, MI, USA
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27
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Delplanque M, Chasset F, Hirsh P, Malard F, Ditchi Y, Fain O, Mekinian A. Lupus cutané érythémateux et histologie compatible avec une maladie de Kikuchi-Fujimoto associés à un syndrome myélodysplasique. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Kikuchi-Fujimoto disease is a form of a benign necrotizing lymphadenitis which is most commonly misdiagnosed as tuberculosis and or lymphoma, usually more common among young adults in Asia. It is a benign disease but can mimic a lot of other disease processes spanning infectious, rheumatologic and even hematologic malignancies. Our patient presented with prolonged fever and lymphadenopathy. Initial considerations were lymphoma and a nonspecific viral infection. A CT scan showed diffuse cervical lymphadenopathy with lacrimal gland involvement. An excisional lymph node biopsy was done which revealed Kikuchi disease. Patient was given steroids with immediate response with defervescence. Kikuchi is a disease with many mimics and a complete workup is needed to exclude serious disease like malignancy.
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Affiliation(s)
- Kevin Bryan Lo
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, 19141, USA
| | - Anna Papazoglou
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, 19141, USA
| | - Lorayne Chua
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, 19141, USA
| | - Nellowe Candelario
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, 19141, USA
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Fragoso T, Fausto V, Pedroza L, Fonseca L, Leite J, Dantas T. LINFONODOMEGALIA GENERALIZADA: DOENÇA DE KIKUCHI EM PACIENTE COM DOENÇA MISTA DO TECIDO CONJUNTIVO. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.07.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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30
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DOENÇA DE KIKUCHI‐FUJIMOTO COMO MANIFESTAÇÃO INICIAL DO LUPUS ERITEMATOSO SISTÊMICO. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.07.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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31
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LÚPUS ERITEMATOSO CUTÂNEO PROFUNDO SIMULA LINFOMA DE CÉLULAS T SUBCUTÂNEO PANICULITE‐SÍMILE E ALÉM DISSO PODE ASSOCIAR‐SE A DOENÇA DE KIKUCHI‐FUJIMOTO. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.07.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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