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Jiwani RA, Jourdan DN, Pona A, Donthi D, Stalls JS, Rehana RW. Kikuchi Fujimoto disease: sinister presentation, good prognosis. J Community Hosp Intern Med Perspect 2021; 11:72-75. [PMID: 33552420 PMCID: PMC7850461 DOI: 10.1080/20009666.2020.1824332] [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] [Indexed: 11/24/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a rare, benign, self-limiting necrotizing lymphadenitis of unknown etiology. The disease can affect people of all ages and of any sex and ethnicity. Tissue biopsy is needed for accurate diagnosis. The condition commonly masquerades as more sinister conditions such as malignancy and rheumatologic disorders, but has a much better prognosis. Treatment is generally supportive but patients may require corticosteroids with eventual spontaneous resolution. We discuss a case of KFD in a 34-year-old male and highlight the need for prompt and accurate diagnosis.
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Affiliation(s)
- Rahim A Jiwani
- Department of Internal Medicine, East Carolina University/Brody School of Medicine, Greenville, NC, USA
| | - Daniel N Jourdan
- Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Adrian Pona
- Department of Internal Medicine, East Carolina University/Brody School of Medicine, Greenville, NC, USA
| | - Deepak Donthi
- Department of Pathology and Laboratory Medicine, East Carolina University/Brody School of Medicine, Greenville, NC, USA
| | - J Stephen Stalls
- Department of Pathology and Laboratory Medicine, East Carolina University/Brody School of Medicine, Greenville, NC, USA
| | - Rita W Rehana
- Department of Internal Medicine, Henry Ford Macomb Hospital, Clinton Township, USA
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Escudier A, Courbage S, Meignin V, Abbou S, Sauvion S, Houlier M, Galerne A, Gaudelus J, de Pontual L, Simonin M. [Kikuchi-Fujimoto disease mimicking malignant lymphoma in adolescents]. Arch Pediatr 2017; 24:471-475. [PMID: 28365190 DOI: 10.1016/j.arcped.2017.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/05/2016] [Accepted: 02/21/2017] [Indexed: 10/19/2022]
Abstract
Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis, is a rare cause of lymphadenopathy in children. This benign disease can mimic lymphoma and misleads doctors. It was first described in Asia, where it occurred especially in young women. Recent publications show that it can also affect teenagers and young adults in Caucasian populations. The pathophysiology remains unknown. Three hypotheses have been raised for this disease: the role of viruses (in particular HHV-8), genetic predisposition (two alleles in HLA class II genes were found more frequently in patients with Kikuchi disease), and an autoimmune cause because of the correlation with lupus erythematosus. Few cases have been reported in Europe so far. In this article, we report three cases of Kikuchi disease observed in less than 2 months in a single hospital in France. All three patients were teenagers who presented with lymphadenopathy, either isolated or combined with fever, weakness, and weight loss. In all of them, the hypermetabolic activity of the lymph node on the PET scanner misled us to suspect lymphoma. The diagnosis of Kikuchi disease was finally made, for all patients, after 2 weeks in the hospital based on lymph node biopsy. Based on this report, we highlight that early biopsy in presence of lymphadenopathy can avoid unnecessary extensive investigations. Moreover, in this rare disease, it is very surprising to come across three cases that are not family-related, in such a short period of time. This strengthens the hypothesis of the possible implication of an environmental factor in the pathophysiology of Kikuchi disease.
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Affiliation(s)
- A Escudier
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - S Courbage
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - V Meignin
- Service d'anatomopathologie, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - S Abbou
- Département de pédiatrie, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif cedex, France
| | - S Sauvion
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - M Houlier
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - A Galerne
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - J Gaudelus
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - L de Pontual
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - M Simonin
- Service de pédiatrie générale, hôpital Jean-Verdier, hôpitaux universitaires Paris-Seine-Saint-Denis, AP-HP, avenue du 14-Juillet, 93143 Bondy cedex, France; Département de pédiatrie, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif cedex, France.
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