A case report on Kikuchi disease

Authors

  • Jyotika Waghray Department of ENT, SVS Medical College and Hospital, Mahabubnagar, Telangana, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20221887

Keywords:

Kikuchi-Fujimoto (KFD), Necrotizing lymphadenitis, Systemic lupus erythematosus (SLE), ANA profile, Perinodal

Abstract

Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a benign and self-limited disease that mainly affects young women. Patients present with localized lymphadenopathy, fever, and leukopenia in up to half of the cases. KFD can occur in association with systemic lupus erythematosus. We present the case of a patient with KFD and systemic lupus erythematosus. A 38 years old female presented with right sided cervical lymphadenopathy, fever and a rash on the face, with a loss of apetite and generalized body weakness. After a series of investigations to rule out other conditions like tuberculosis, a diagnosis of kikuchi disease was made based on the biopsy report. There was a strong suspiscion of SLE as well pertaining to the facial rash. An ANA profile was done which strongly indicated SLE as well. The patient was started on steroids and other systematic treatment and recovered gradually. With its shared clinical features, Kikuchi-Fujimoto disease can be mistaken for other forms of lymphadenitis. A combined use of medical imaging and laboratory tests is the effective way to avoid misdiagnosis.

References

Lopez C, Oliver M, Olavarria R, Sarabia MA, Chopite M. Kikuchi-Fujimoto necrotizing lymphadenitis associated with cutaneous lupus erythematosus: a case report. Am J Dermatopathol. 2000;22(4):328-33.

Kaur S, Thami GP, Kanwar AJ. Kikuchi's disease, skin and systemic lupus erythematosus. Br J Dermatol. 2002;146(1):167-8.

Norris AH, Krasinskas AM, Salhany KE, Gluckman SJ. Kikuchi-Fujimoto disease: a benign cause of fever and lymphadenopathy. Am J Med. 1996;101(4):401-5.

Loachim HL, Ratech H. Loachim's Lymph Node Pathology. 3rd ed. New York: Lippincott Williams and Wilkins; 2002.

Chen HC, Lai JH, Huang GS, Gao HW, Chen CH, Kuo SY, et al. Systemic lupus erythematosus with simultaneous onset of Kikuchi-Fujimoto's disease complicated with antiphospholipid antibody syndrome: a case report and review of the literature. Rheumatol Int. 2005;25(4):303-6.

Santana A, Lessa B, Galrao L, Lima I, Santiago M. Kikuchi-Fujimoto's disease associated with systemic lupus erythematosus: case report and review of the literature. Clin Rheumatol. 2005;24(1):60-3.

Litwin MD, Kirkham B, Henderson DR, Milazzo SC. Histiocytic necrotising lymphadenitis in systemic lupus erythematosus. Ann Rheum Dis. 1992;51(6):805-7.

Vila LM, Mayor AM, Silvestrini IE. Therapeutic response and long-term follow-up in a systemic lupus erythematosus patient presenting with Ki-kuchi's disease. Lupus. 2001;10(2):126-8.

Meyer O, Kahn MF, Grossin M, Ribard P, Belmatoug N, Morinet F, et al. Parvovirus B19 infection can induce histiocytic necrotizing lymphadenitis (Kikuchi's disease) associated with systemic lupus erythematosus. Lupus. 1991;1(1):37-41.

Tumiati B, Casoli P, Perazzoli F, Cavazza A. Necrotizing lymphadenitis in systemic lupus erythematosus. Kikuchi's disease or a Kikuchi's-like disease? J Clin Rheumatol. 1999;5:121-5.

Menasce LP, Banerjee SS, Edmondson D, Harris M. Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): continuing diagnostic difficulties. Histopathology. 1998;33(3):248-54.

Marrack P, Kappler J, Kotzin BL. Autoimmune disease: why and where it occurs. Nat Med. 2001;7(8):899-905.

Gross DM, Forsthuber T, Tary-Lehmann M, Etling C, Ito K, Nagy ZA, et al. Identification of LFA-1 as a candidate auto-antigen in treatment-resistant Lyme arthritis. Science. 1998;281(5377):703-6.

Botto M. Links between complement deficiency and apoptosis. Arthritis Res. 2001;3(4):207-10.

Coppola M, Yealy DM. Relapsing polychondritis: an unusual cause of painful auricular swelling. Ann Emerg Med. 1992;21(1):81-5.

Balsa A, Expinosa A, Cuesta M, MacLeod TI, Gijon-Banos J, Maddison PJ. Joint symptoms in relapsing polychondritis. Clin Exp Rheumatol. 1995;13(4):425-30.

Herman JH, Carpenter BA. Immunobiology of cartilage. Semin Arthritis Rheum. 1975;5(1):1-40.

Campbell RD. The molecular genetics of components of the complement system. Baillieres Clin Rheumatol. 1988;2(3):547-75.

Schumaker VN, Zavodszky P, Poon PH. Activation of the first component of complement. Annu Rev Immunol. 1987;5:21-42.

Lachmann PJ. Complement-friend or foe? Br J Rheumatol. 1987;26(6):409-15.

Downloads

Published

2022-07-26

Issue

Section

Case Reports