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Hurtado-Díaz J, Espinoza-Sánchez ML, Rojas-Milán E, Cimé-Aké E, de Los Ángeles Macias M, Romero-Ibarra L, Vera-Lastra OL. Kikuchi-Fujimoto Disease: Report of a Case with Progression to Lupus Nephritis. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e927351. [PMID: 33677464 PMCID: PMC7949488 DOI: 10.12659/ajcr.927351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patient: Female, 28-year-old Final Diagnosis: Kikuchi-Fujimoto Lymphadenitis • lupus nephritis Symptoms: Agitation • anxiety • arthralgia • diarhea • fatigue • fever • headache • lymfadenopathy • sweating • weigh loss Medication: — Clinical Procedure: — Specialty: Rheumatology
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Affiliation(s)
- Jorge Hurtado-Díaz
- Department of Internal Medicine, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico
| | - María Lucero Espinoza-Sánchez
- Department of Internal Medicine, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico
| | - Eduardo Rojas-Milán
- Department of Internal Medicine, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico
| | - Erik Cimé-Aké
- Department of Internal Medicine, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico
| | - María de Los Ángeles Macias
- Department of Pathological Anatomy, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico
| | - Lizeth Romero-Ibarra
- Department of Internal Medicine, Hospital General Regional N° 251, Metepec, Mexico
| | - Olga Lidia Vera-Lastra
- Department of Internal Medicine, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico.,Division of Postgraduate Studies, Faculty of Medicine, National University Autonomous of Mexico, México City, Mexico
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Lahma J, Arkoubi Z, Hejjouji R, Nitassi S, El Ayoubi A, Bencheikh R, Benbouzid MA, Oujilal A, Essakalli L. About a rare disease misdiagnosed as malignant lymphoma or tuberculosis: Kikuchi-Fujimoto's disease. Pan Afr Med J 2019; 31:77. [PMID: 31007824 PMCID: PMC6457726 DOI: 10.11604/pamj.2018.31.77.16569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022] Open
Abstract
Kikuchi-Fujimoto's disease KFD is a rare and benign cause of cervical lymphadenopathy. It is an anatomoclinical entity of unknown etiology. The confirmation of the diagnosis is always provided by histological lymph node study. The clinical picture sometimes evokes lymphoma or tuberculosis. The evolution is generally favorable with spontaneous healing after a few weeks. We report the case of a 26-year-old woman who had consulted for cervical lymphadenopathy associated with fever. The cervical lymph node biopsy concluded to Kikuch-Fujimoto's disease. The evolution was marked by rapid regression of lymphadenopathy under corticosteroid treatment.
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Affiliation(s)
- Jawad Lahma
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Zakaria Arkoubi
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Reda Hejjouji
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Sophia Nitassi
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Ali El Ayoubi
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Razika Bencheikh
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | | | - Abdelilah Oujilal
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Leila Essakalli
- ENT Department, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
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[Fever associated with lips and eyelid edema in a 16 year-old woman]. Rev Med Interne 2018; 40:52-55. [PMID: 30054109 DOI: 10.1016/j.revmed.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 07/01/2018] [Indexed: 11/21/2022]
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Elfihri S, Laine M, Kettani F, Ben Amor J, Bourkadi JE. [Kikuchi-Fujimoto disease: about a case]. Pan Afr Med J 2017; 27:144. [PMID: 28904672 PMCID: PMC5567932 DOI: 10.11604/pamj.2017.27.144.12102] [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: 02/26/2017] [Accepted: 06/12/2017] [Indexed: 11/11/2022] Open
Abstract
Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a rare cause of benign cervical adenopathies. It is an anatomoclinic entity of unknown cause. Diagnosis is based on histologic examination of the lymph nodes. Patient's evolution is generally favorable with spontaneous healing after a few weeks. We here report the case of a 9-year old girl presenting with cervical lymphadenopathy associated with fever. Cervical lymph node biopsy showed Kikuchi-Fujimoto disease. Patient's evolution was marked by regression of adenopathies without receiving any treatment.
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Affiliation(s)
- Sanaa Elfihri
- Service de Pneumo-Phtisiologie, Hôpital Moulay Youssef, CHU Ibn Sina, Rabat, Maroc
| | - Mustapha Laine
- Service de Pneumo-Phtisiologie, Hôpital Moulay Youssef, CHU Ibn Sina, Rabat, Maroc
| | - Fouad Kettani
- Laboratoire d'Anatomie Pathologique Nations Unies, Rabat, Maroc
| | - Jaouda Ben Amor
- Service de Pneumo-Phtisiologie, Hôpital Moulay Youssef, CHU Ibn Sina, Rabat, Maroc
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Lame CA, Loum B, Fall AK, Cucherousset J, Ndiaye AR. Kikuchi-Fujimoto disease, a rare cause of lymphadenopathy in Africa. Description of the first case in Senegal and review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:347-349. [PMID: 28279633 DOI: 10.1016/j.anorl.2017.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is a benign disease most commonly affecting adult females. It generally presents in the form of febrile cervical lymphadenopathy. This diagnosis must be considered in the setting of tropical medicine, dominated by a high prevalence of tuberculous lymphadenitis and haematological malignancies. CASE REPORT The authors report the case of a 33-year-old Senegalese woman who presented with subacute cervical lymphadenopathy associated with fever and laboratory signs of inflammation. Serological and tuberculosis screening tests were negative. Histopathological examination of a lymph node biopsy, following failure of nonspecific antibiotic therapy, concluded on a diagnosis of Kikuchi-Fujimoto disease. A favourable course was observed in response to corticosteroid therapy. CONCLUSION In Sub-Saharan Africa, the association of polyadenitis and febrile syndrome, after excluding tuberculosis and lymphomas, must raise the suspicion of rare diseases such as Kikuchi-Fujimoto disease.
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Affiliation(s)
- C-A Lame
- Service ORL, Hôpital Principal de Dakar, 11, rue Jean Mermoz, Dakar, Senegal.
| | - B Loum
- Service ORL, Hôpital Principal de Dakar, 11, rue Jean Mermoz, Dakar, Senegal
| | - A-K Fall
- Service de Médecine interne, Hôpital Principal de Dakar, 11, rue Jean Mermoz, Dakar, Senegal
| | - J Cucherousset
- Service de Pathologie, GHI Le RAINCY-MONTFERMEIL, 10, rue du Général Leclerc, 93370 Montfermeil, France
| | - A-R Ndiaye
- Service de Médecine interne, Hôpital Principal de Dakar, 11, rue Jean Mermoz, Dakar, Senegal
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Acute Liver Failure Secondary to Hemophagocytic Lymphohistiocytosis during Pregnancy. ACG Case Rep J 2016; 3:e162. [PMID: 27921061 PMCID: PMC5126497 DOI: 10.14309/crj.2016.135] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 05/25/2016] [Indexed: 11/17/2022] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive immune activation that mimics and occurs with other systemic diseases. A 35-year-old female presented with signs of viral illness at 13 weeks of pregnancy and progressed to acute liver failure (ALF). We discuss the diagnosis of HLH and Kikuchi-Fujimoto (KF) lymphadenitis in the context of pregnancy and ALF. HLH may respond to comorbid disease-specific therapy, and more toxic treatment can be avoided.
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Simultaneous Acquired Self-limited Hemophagocytic Lymphohistiocytosis and Kikuchi Necrotizing Lymphadenitis in a 16-Year-Old Teenage Girl: A Case Report and Review of the Literature. Pediatr Emerg Care 2016; 32:792-798. [PMID: 26555310 DOI: 10.1097/pec.0000000000000560] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The aim of this study was to increase education and awareness among pediatric practitioners of possibility of simultaneous hemophagocytic lymphohistiocytosis and Kikuchi-Fujimoto disease/Kikuchi disease occurring in the pediatric population and the diagnostic dilemma it can present. We describe a case presentation of acquired and self-limited simultaneous hemophagocytic lymphohistiocytosis and Kikuchi-Fujimoto disease in a 16-year-old in the United States who presented with fevers, night sweats, and joint pain, along with tiredness and decreased appetite along with pancytopenia and elevated lactate dehydrogenase. To the best of our knowledge, simultaneous hemophagocytic lymphohistiocytosis and Kikuchi-Fujimoto in the pediatric population has not been described in North America but remains fairly common in Asia. The literature on both diseases and their simultaneous occurrence is comprehensively reviewed. METHODS This was a case report and review of the literature. RESULTS The patient was diagnosed with both hemophagocytic lymphohistiocytosis and Kikuchi-Fujimoto disease based on bone marrow aspiration/biopsy and axillary node biopsy, respectively. Both illnesses resolved completely. CONCLUSIONS Benign causes of pancytopenia and elevated lactate dehydrogenase exist, but they may not be always straightforward diagnostically. Bone marrow aspiration and lymph node biopsy may be helpful in ascertaining the diagnosis. Hemophagocytic lymphohistiocytosis and Kikuchi-Fujimoto disease may represent a continuum of illness.
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Abstract
Kikuchi-Fujimoto disease (KFD) is a rare cause of lymphadenopathy, most often cervical. It has been mainly described in Asia. There are few data available on this disease in Europe. We conducted this retrospective, observational, multicenter study to describe KFD in France and to determine the characteristics of severe forms of the disease and forms associated with systemic lupus erythematosus (SLE). We included 91 cases of KFD, diagnosed between January 1989 and January 2011 in 13 French hospital centers (median age, 30 ± 10.4 yr; 77% female). The ethnic origins of the patients were European (33%), Afro-Caribbean (32%), North African (15.4%), and Asian (13%). Eighteen patients had a history of systemic disease, including 11 with SLE. Lymph node involvement was cervical (90%), often in the context of polyadenopathy (52%), and it was associated with hepatomegaly and splenomegaly in 14.8% of cases. Deeper sites of involvement were noted in 18% of cases. Constitutional signs consisted mainly of fever (67%), asthenia (74.4%), and weight loss (51.2%). Other manifestations included skin rash (32.9%), arthromyalgia (34.1%), 2 cases of aseptic meningitis, and 3 cases of hemophagocytic lymphohistiocytosis. Biological signs included lymphocytopenia (63.8%) and increase of acute phase reactants (56.4%). Antinuclear antibodies (ANAs) and anti-DNA antibodies were present in 45.2% and 18% of the patients sampled, respectively. Concomitant viral infection was detected in 8 patients (8.8%). Systemic corticosteroids were prescribed in 32% of cases, hydroxychloroquine in 17.6%, and intravenous immunoglobulin in 3 patients. The disease course was always favorable. Recurrence was observed in 21% of cases. In the 33 patients with ANA at diagnosis, SLE was known in 11 patients, diagnosed concomitantly in 10 cases and in the year following diagnosis in 2 cases; 6 patients did not have SLE, and 4 patients were lost to follow-up (median follow-up, 19 mo; range, 3-39 mo). The presence of weight loss, arthralgia, skin lesions, and ANA was associated with the development of SLE (p < 0.05). Male sex and lymphopenia were associated with severe forms of KFD (p < 0.05). KFD can occur in all populations, irrespective of ethnic origin. Deep forms are common. An association with SLE should be investigated. A prospective study is required to determine the risk factors for the development of SLE.
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Dumas G, Prendki V, Haroche J, Amoura Z, Cacoub P, Galicier L, Meyer O, Rapp C, Deligny C, Godeau B, Aslangul E, Lambotte O, Papo T, Pouchot J, Hamidou M, Bachmeyer C, Hachulla E, Carmoi T, Dhote R, Gerin M, Mekinian A, Stirnemann J, Charlotte F, Farge D, Molina T, Fain O. Kikuchi-Fujimoto disease: retrospective study of 91 cases and review of the literature. Medicine (Baltimore) 2014; 93:372-382. [PMID: 25500707 PMCID: PMC4602439 DOI: 10.1097/md.0000000000000220] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a rare cause of lymphadenopathy, most often cervical. It has been mainly described in Asia. There are few data available on this disease in Europe. We conducted this retrospective, observational, multicenter study to describe KFD in France and to determine the characteristics of severe forms of the disease and forms associated with systemic lupus erythematosus (SLE). We included 91 cases of KFD, diagnosed between January 1989 and January 2011 in 13 French hospital centers (median age, 30 ± 10.4 yr; 77% female). The ethnic origins of the patients were European (33%), Afro-Caribbean (32%), North African (15.4%), and Asian (13%). Eighteen patients had a history of systemic disease, including 11 with SLE. Lymph node involvement was cervical (90%), often in the context of polyadenopathy (52%), and it was associated with hepatomegaly and splenomegaly in 14.8% of cases. Deeper sites of involvement were noted in 18% of cases. Constitutional signs consisted mainly of fever (67%), asthenia (74.4%), and weight loss (51.2%). Other manifestations included skin rash (32.9%), arthromyalgia (34.1%), 2 cases of aseptic meningitis, and 3 cases of hemophagocytic lymphohistiocytosis. Biological signs included lymphocytopenia (63.8%) and increase of acute phase reactants (56.4%). Antinuclear antibodies (ANAs) and anti-DNA antibodies were present in 45.2% and 18% of the patients sampled, respectively. Concomitant viral infection was detected in 8 patients (8.8%). Systemic corticosteroids were prescribed in 32% of cases, hydroxychloroquine in 17.6%, and intravenous immunoglobulin in 3 patients. The disease course was always favorable. Recurrence was observed in 21% of cases. In the 33 patients with ANA at diagnosis, SLE was known in 11 patients, diagnosed concomitantly in 10 cases and in the year following diagnosis in 2 cases; 6 patients did not have SLE, and 4 patients were lost to follow-up (median follow-up, 19 mo; range, 3-39 mo). The presence of weight loss, arthralgia, skin lesions, and ANA was associated with the development of SLE (p < 0.05). Male sex and lymphopenia were associated with severe forms of KFD (p < 0.05). KFD can occur in all populations, irrespective of ethnic origin. Deep forms are common. An association with SLE should be investigated. A prospective study is required to determine the risk factors for the development of SLE.
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Affiliation(s)
- Guillaume Dumas
- From the Department of Internal Medicine (GD, CR), Hôpital d'Instruction des Armées Bégin, Saint-Mandé; Department of Internal Medicine 2 (JH, ZA), Pitié-Salpêtrière University Hospital, Paris; Department of Internal Medicine (PC), Pitié-Salpêtrière University Hospital, Paris; Department of Clinical Immunology (LG), Saint-Louis University Hospital, Paris; Department of Rheumatology (OM), Bichat University Hospital, Paris; Department of Internal Medicine (CD), Martinique University Hospital, Fort-de-France; Department of Internal Medicine (BG), Mondor University Hospital, Créteil; Department of Internal Medicine (EA), Cochin University Hospital, Paris; Department of Internal Medicine (OL), Bicêtre University Hospital, Le Kremlin-Bicêtre; Department of Internal Medicine (TP), Bichat University Hospital, Paris; Hôpital Européen Georges Pompidou (JP), Paris; Department of Internal Medicine (MH), Hôtel-Dieu University Hospital, Nantes; Department of Internal Medicine (CB), Tenon University Hospital, Paris; Department of Internal Medicine (EH), Huriez University Hospital, Lille; Department of Internal Medicine (TC), Hôpital d'Instruction des Armées du Val de Grace, Paris; Department of Internal Medicine (RD), Avicenne University Hospital, Bobigny; Department of Internal Medicine (MG, AM, OF), Jean Verdier University Hospital, Bondy; Department of Pathology (FC), Pitié-Salpêtrière University Hospital, Paris; Department of Internal Medicine (DF), Saint-Louis University Hospital, Paris; Department of Pathology (TM), Necker University Hospital, Paris; France; and Department of Internal Medicine (VP), Hôpital des Trois-Chêne, Hôpitaux Universitaires de Genève, Genève; and Department of Internal Medicine (JS), Hôpitaux Universitaires de Genève, Genève, Switzerland. Drs. Prendki and Fain contributed equally
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Méni C, Chabrol A, Wassef M, Gautheret-Dejean A, Bergmann JF, Mouly S. [An atypical presentation of Kikuchi-Fujimoto disease]. Rev Med Interne 2012. [PMID: 23200797 DOI: 10.1016/j.revmed.2012.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) is a rare clinical entity characterized by the association of enlarged lymph nodes in the posterior cervical region and fever. The disease is more frequent in young women. CASE REPORT We report a 41-year-old African patient who presented with atypical features of Kikuchi's disease including cutaneous lupus, haemophagocytosis, and lymphocytic meningitis. The ethnic origin and the clinical presentation were initially suggestive of tuberculous meningitis. However, microbiological analyses remained negative, histological findings were suggestive of Kikuchi's disease and HHV6 DNA integration was documented in our patient. CONCLUSION Kikuchi's disease should be suspected in an African patient when lymphocytic meningitis is associated with enlarged cervical lymph nodes, hemophagocytosis and HHV6 DNA integration.
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Affiliation(s)
- C Méni
- Service de médecine interne A, hôpital Lariboisière, université Paris Cité-Diderot, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
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Marrec C, Picherot G, Kandel C, Caquard M. Une cause rare chez l’enfant de poly-adénopathie fébrile : la maladie de Kikuchi–Fujimoto. Arch Pediatr 2012; 19:38-41. [DOI: 10.1016/j.arcped.2011.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 06/06/2011] [Accepted: 10/06/2011] [Indexed: 11/30/2022]
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Abraham M, Lazareth I, Bonardel G, Albiges L, Dechaud C, Marini V, Michon-Pasturel U, Molinier V, Priollet P. [Kikuchi disease and lupus: case report, literature review and FDG PET/CT interest]. ACTA ACUST UNITED AC 2011; 36:274-9. [PMID: 21757306 DOI: 10.1016/j.jmv.2011.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 05/11/2011] [Indexed: 12/17/2022]
Abstract
Kikuchi disease is a rare entity characterized by lymphadenopathy and fever. Pathology study of lymph node biopsies provides the diagnosis. The disease course is favorable. The disease can occur isolated, or associated with other pathologies including lupus or mixed connective tissue disease. We report a case of Kikuchi disease in a 35-year-old woman, occurring 12 years after the diagnosis of overlap syndrome with antiphospholipid antibodies. The patient was given prednisone 25mg per day and long-term hydroxychloroquine. FDG PET/CT showed FDG-avidity nodular masses. After bolus corticosteroid therapy, outcome was favorable with disappearance of metabolic hyperactivity on the FDG PET/CT. The bolus prednisone treatment could then be discontinued. In the 61 cases of Kikuchi disease and lupus associations previously published, Kikuchi disease was diagnosed after lupus in only 13 % of the observations. In these cases, use of FDG PET/ CT was not reported. For us, FDG PET/CT was useful for diagnosis, for choosing the biopsy site and for follow-up.
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Affiliation(s)
- M Abraham
- Service de médecine vasculaire, groupe hospitalier Paris Saint-Joseph, France
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Han KM, Go JH, Myong NH, Lee W. Fine Needle Aspiration Cytology of Kikuchi's Lymphadenitis: with Emphasis on Differential Diagnosis with Tuberculosis. KOREAN JOURNAL OF PATHOLOGY 2011. [DOI: 10.4132/koreanjpathol.2011.45.6.626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kang Min Han
- Department of Pathology, Dankook University College of Medicine, Cheonan, Korea
| | - Jai Hyang Go
- Department of Pathology, Dankook University College of Medicine, Cheonan, Korea
| | - Na Hye Myong
- Department of Pathology, Dankook University College of Medicine, Cheonan, Korea
| | - Wonae Lee
- Department of Pathology, Dankook University College of Medicine, Cheonan, Korea
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