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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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Rush ML, Mauro A, Bhansali P. Kimura disease: a case report of a rare illness presenting as a common complaint. ACTA ACUST UNITED AC 2020; 6:393-396. [PMID: 30808157 DOI: 10.1515/dx-2018-0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/28/2019] [Indexed: 12/29/2022]
Abstract
Background Kimura is an uncommon inflammatory cause of pediatric head and neck masses due to eosinophilic infiltration of unclear etiology. Kimura can present similarly to infectious lymphadenitis, a much more common pediatric complaint. This case explores the role of anchoring bias when faced with an illness that at first appears to fit a common illness script that led to a delayed diagnosis. Case presentation A 7-year-old boy presented with acute onset of pre-auricular lymphadenopathy and fevers initially thought to be most consistent with infectious cervical lymphadenopathy. Despite treatment with broad spectrum antibiotics and multiple evaluations for underlying abscess requiring surgical drainage, the patient did not improve and remained febrile. Eventually, excisional lymph node biopsy was obtained and a pathologic diagnosis of Kimura disease was made. Conclusions This case illustrates an uncommon pediatric diagnosis which presented similarly to infectious cervical lymphadenitis without additional laboratory features consistent with Kimura. We highlight the role of anchoring bias and care fragmentation leading to repeat imaging and delayed biopsy in the eventual diagnosis of a rare illness.
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Affiliation(s)
| | - Alexandra Mauro
- Children's National Medical Center, Washington, DC, USA.,Walter Reed National Military Medical Center and George Washington University, Washington, DC, USA
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Grozdic Milojevic I, Tadic M, Sobic-Saranovic D, Saponjski J, Artiko VM. Hybrid Imaging in Head and Neck Sarcoidosis. J Clin Med 2019; 8:E803. [PMID: 31195715 PMCID: PMC6617001 DOI: 10.3390/jcm8060803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 12/19/2022] Open
Abstract
Abstract: To determine the prevalence of head and neck sarcoidosis (HNS) and evaluate the role of hybrid molecular imaging in HNS. Between 2010 and 2018, 222 patients with chronic sarcoidosis and presence of prolonged symptoms of active disease were referred to FDG PET/CT. Active disease was found in 169 patients, and they were all screened for the presence of HNS. All patients underwent MDCT and assessment of the serum ACE level. Follow-up FDG PET/CT examination was done 19.84 ± 8.98 months after the baseline. HNS was present in 38 out of 169 patients. FDG uptake was present in: cervical lymph nodes (38/38), submandibular glands (2/38), cerebrum (2/38), and bone (1/38). The majority of patients had more than two locations of disease. After FDG PET/CT examination, therapy was changed in most patients. Fourteen patients returned to follow-up FDG PET/CT examination in order to assess the therapy response. PET/CT revealed active disease in 12 patients and complete remission in two patients. Follow-up ACE levels had no correlation with follow-up SUVmax level (ρ = -0.18, p = 0.77). FDG PET/CT can be useful in the detection of HNS and in the evaluation of the therapy response. It may replace the use of non-purposive mounds of insufficiently informative laboratory and radiological procedures.
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Affiliation(s)
- Isidora Grozdic Milojevic
- Center for Nuclear Medicine, Clinical Center of Serbia, 11000 Belgrade, Serbia.
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
| | - Marijana Tadic
- Department of Internal Medicine and Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), 13353 Berlin, Germany.
| | - Dragana Sobic-Saranovic
- Center for Nuclear Medicine, Clinical Center of Serbia, 11000 Belgrade, Serbia.
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
| | - Jelena Saponjski
- Center for Nuclear Medicine, Clinical Center of Serbia, 11000 Belgrade, Serbia.
| | - Vera M Artiko
- Center for Nuclear Medicine, Clinical Center of Serbia, 11000 Belgrade, Serbia.
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
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Bag AK, Curé JK, Chapman PR, Singhal A, Haneef Mohamed AW. Imaging of Inflammatory Disorders of Salivary Glands. Neuroimaging Clin N Am 2018; 28:255-272. [PMID: 29622118 DOI: 10.1016/j.nic.2018.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sialadenitis is among the most common conditions that affect the salivary glands. Inflammation of the salivary glands occurs as the end result of a variety of pathologic conditions, including infectious, autoimmune, and idiopathic causes. Clinically, inflammation of the salivary gland causes pain and localized swelling. The presentation may be acute or chronic, and can be recurrent. Because there is significant overlap of underlying disease mechanisms and clinical presentations, radiologic evaluation often plays a significant role in evaluation. This article is a brief review of sialadenitis, including disease mechanisms, causes, and the practical imaging of the salivary glands.
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Affiliation(s)
- Asim K Bag
- Department of Radiology, University of Alabama at Birmingham, JT N432, 619 19th Street South, Birmingham, AL 35249, USA.
| | - Joel K Curé
- Department of Radiology, University of Alabama at Birmingham, JT N432, 619 19th Street South, Birmingham, AL 35249, USA
| | - Philip R Chapman
- Department of Radiology, University of Alabama at Birmingham, JT N432, 619 19th Street South, Birmingham, AL 35249, USA
| | - Aparna Singhal
- Department of Radiology, University of Alabama at Birmingham, JT N432, 619 19th Street South, Birmingham, AL 35249, USA
| | - Atif Wasim Haneef Mohamed
- Department of Radiology, University of Alabama at Birmingham, JT N432, 619 19th Street South, Birmingham, AL 35249, USA
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Aziz A, Mohamad I, Zawawi N. Kimura Disease: A differential diagnosis in a nephrotic child. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2018; 13:32-35. [PMID: 30302182 PMCID: PMC6173965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Kimura disease presents as benign lesion and is commonly present among the Asian population. It is a disease with a favourable prognosis and a peak age of onset in the third decade. It is a chronic inflammatory disorder of unknown etiology that involves the lymph nodes and subcutaneous tissues of the head and neck region. We report a case of a 15-year-old boy with multiple Kimura lymphadenopathies involving the left posterior auricular region as well as the anterior and posterior triangles of the neck.
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Affiliation(s)
- A Aziz
- MB Bch BAO, Department of Otorhinolaryngology Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu Kelantan, Malaysia.
| | - I Mohamad
- MMed ORL-HNS Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu Kelantan, Malaysia
| | - N Zawawi
- MPath, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kota Bharu Kelantan, Malaysia
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Trivedi ND, Parsons AS. Kikuchi-Fujimoto disease: an unusual presentation of meningitis in a returning traveller. BMJ Case Rep 2017; 2017:bcr-2017-221422. [PMID: 29170173 DOI: 10.1136/bcr-2017-221422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 19-year-old, previously healthy woman developed a pruritic erythematous maculopapular rash on her bilateral palms and wrists, right-sided tender cervical lymphadenopathy and nightly fevers and headaches 5 days after returning from a 1-month trip to Cambodia. She presented 2 weeks after her trip due to ongoing nightly fevers to a maximum of 38.8°C. She was given empiric doxycycline for possible rickettsial disease, though an extensive infectious workup returned without positive findings. Lumbar puncture was performed on hospital day 4, and spinal fluid analysis was consistent with aseptic meningitis. On hospital day 5, core biopsy and fine-needle aspiration were performed on the largest anterior cervical lymph node. Her fever curve gradually improved, and she was discharged on hospital day 6. Results of the lymph node biopsy were finalized 5 days after discharge and were compatible with Kikuchi's lymphadenitis. Symptoms had completely resolved on follow-up with infectious disease and rheumatology.
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Sarcoidosis in the Head and Neck: An Illustrative Review of Clinical Presentations and Imaging Findings. AJR Am J Roentgenol 2017; 208:66-75. [DOI: 10.2214/ajr.16.16058] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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8
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Rodrigues G, Ravi B. Synchronous Kimura lesions at two different sites-a diagnostic dilemma! Quant Imaging Med Surg 2016; 6:214-7. [PMID: 27190775 PMCID: PMC4858467 DOI: 10.21037/qims.2015.08.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/03/2015] [Indexed: 11/06/2022]
Abstract
Kimura disease (KD) is a rare, chronic, benign inflammatory disorder of unknown etiology mimicking neoplastic disease and is characterized by multiple subcutaneous nodules and masses, primarily in the cervical region, accompanied by peripheral eosinophilia and lymphadenopathy. A 35-year-old male presented with a 2-year history of swelling in the right preauricular region and right thigh. Investigations showed a peripheral eosinophilia. CT of cervical region revealed parotid neoplasm and a fine needle aspiration was inconclusive. The thigh swelling felt vascular and a CT angiogram was done which revealed a diffuse vascular lesion. A superficial parotidectomy and an excision of the right thigh swelling were done. Histopathologies of both specimens were reported to have features suggestive of KD. The patient was evaluated for systemic manifestations and found to have no abnormalities. The patient has been disease free on follow-up after 2 years. This case is being presented for the rarity of its incidence and the nature of its presentation.
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Affiliation(s)
- Gabriel Rodrigues
- Department of General Surgery, Kasturba Medical College, Manipal University, Manipal 576104, India
| | - Bharadwaj Ravi
- Department of General Surgery, Kasturba Medical College, Manipal University, Manipal 576104, India
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Abstract
The cervical lymph nodes can be affected by a variety of infectious, inflammatory, benign, and malignant pathologic conditions. Clinical history and physical examination with the complementary use of imaging is essential to accurately make a diagnosis or appropriate differential. Knowledge of cervical lymph node anatomy, drainage pathways, morphologic variations, and common nodal pathology is key to correct interpretation of cervical lymph nodes on imaging. Computed tomography (CT), MR, ultrasound, and PET/CT are complementary imaging modalities that can be used in the evaluation of cervical lymph node pathology.
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Affiliation(s)
- Laura B Eisenmenger
- Department of Radiology, University of Utah, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA; Department of Biomedical Informatics, University of Utah, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA
| | - Richard H Wiggins
- Department of Radiology, University of Utah, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA; Department of Biomedical Informatics, University of Utah, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA; Division of Otolaryngology-Head and Neck Surgery, University of Utah, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA.
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Bezek S, Tucci V, Kalra S, Fisher A. State of the globe: time to revisit kikuchi fujimoto disease. J Glob Infect Dis 2014; 6:139-40. [PMID: 25538450 PMCID: PMC4265827 DOI: 10.4103/0974-777x.145228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sarah Bezek
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Veronica Tucci
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Sarathi Kalra
- Department of Trauma Surgery, St. Luke's University Hospital, Bethlehem, Pennsylvania, USA
| | - Angela Fisher
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
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Mrówka-Kata K, Kata D, Kyrcz-Krzemień S, Sowa P. Kikuchi-Fujimoto disease as a rare cause of lymphadenopathy--two cases report and review of current literature. Otolaryngol Pol 2013; 67:1-5. [PMID: 23374656 DOI: 10.1016/j.otpol.2012.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 02/22/2012] [Accepted: 02/23/2012] [Indexed: 11/30/2022]
Abstract
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a benign and self-limited disease, characterized typically by enlargement of regional lymph nodes accompanied by fever. KFD affects predominantly young adult females of Asian origin and is rarely seen in European countries, where it may cause diagnostic difficulties. Two cases of KFD in a 33 and 27-year-old woman with mild fever, malaise, lymphadenopathy initially misdiagnosed for indolent non-Hodgkin's lymphoma was presented. The definitive diagnosis was established on the basis of histopathological examination of totally excised cervical lymph nodes. The propriety diagnosis allowed us to avoid inappropriate chemotherapy. The disease course in our patient was uneventful during the 1.5 and 12-year follow-up period. The clinical presentations, complications as well as current concepts on pathogenesis, diagnosis and treatment of the Kikuchi-Fujimoto disease was briefly reviewed in this paper. The need of a long-term follow-up of patients with Kikuchi-Fujimoto disease was emphasized.
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Affiliation(s)
- Katarzyna Mrówka-Kata
- Katedra i Oddział Kliniczny Laryngologii w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach, ul. M. Skłodowskiej-Curie 10, 41-800 Zabrze, Poland.
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Kimura's disease: clinicopathological study of eight cases. The Journal of Laryngology & Otology 2013; 127:170-4. [DOI: 10.1017/s0022215112003040] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Kimura's disease is a rare, localised, chronic inflammatory disease. This benign disease involves subcutaneous tissues, the major salivary gland, and lymph nodes primarily in the head and neck area.Method:Clinical details and stained slides of all cases reported as Kimura's disease over a 10-year period were reviewed.Results:There were eight cases of Kimura's disease. The mean age of patients was 22.8 years. One case showed associated nephrotic syndrome and two cases were associated with peripheral blood eosinophilia. All cases showed the typical histopathological features of Kimura's disease.Conclusion:Kimura's disease was first reported in China in 1937. The cause of Kimura's disease is unknown and many theories have been proposed. The eight cases reported here illustrate some of the variations in the mode of presentation and in the histological features of Kimura's disease. Kimura's disease should be considered in the differential diagnosis of patients who present with head and neck swellings and lymphadenopathy, and investigated accordingly.
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Shankar T, Myreddy N, Varalaxmi KP. Kimura's Disease: A Case Report in a Child. Indian J Otolaryngol Head Neck Surg 2012; 66:237-41. [PMID: 24533390 DOI: 10.1007/s12070-011-0446-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 12/26/2011] [Indexed: 10/14/2022] Open
Abstract
Kimura's disease is chronic inflammatory disorder of unknown etiology that most commonly present as painless, unilateral cervical lymphadenopathy, males are more commonly effected than females with 3.5:1-9:1 ratio. Kimura's disease commonly seen in young adults median age being 28-32 years. Here we are presenting a case of Kimura's disease in a 6 year old male child, with a bilateral presentation. The goals of pharmacotherapy for Kimura's disease are to reduce morbidity and to prevent complications. The prognosis for Kimura's disease is good with no potential for malignant transformation.
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Affiliation(s)
- T Shankar
- Department of ENT, Government Medical College, Anantapur, Andhra Pradesh India
| | - Neeraja Myreddy
- Department of Pathology, Government Medical College, Anantapur, Andhra Pradesh India
| | - K P Varalaxmi
- Department of Pathology, Government Medical College, Anantapur, Andhra Pradesh India
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Initial work-up for cervical lymphadenopathy: back to basics. Eur Arch Otorhinolaryngol 2011; 269:2255-63. [DOI: 10.1007/s00405-011-1895-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 12/15/2011] [Indexed: 11/25/2022]
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