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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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2
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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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3
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Qasim A, Itare V, Anwar MY, Arguello Perez E. A Rare Case of Kikuchi-Fujimoto Disease. Cureus 2023; 15:e39098. [PMID: 37332401 PMCID: PMC10270646 DOI: 10.7759/cureus.39098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is an autoimmune condition that is more common in females and occurs in the third decade of life. The condition is usually benign and self-resolving and is characterized by fever, cervical lymphadenopathy, night sweats, myalgia, and rashes. The disease can be misdiagnosed as reactive follicular hyperplasia, tuberculous lymphadenitis, systemic lupus erythematosus, and malignant lymphoma. The diagnosis of KFD involves the excision of the affected lymph node. Although there is no specific treatment for the disease, usually symptomatic and supportive measures are effective; however, steroids and immunosuppressive therapies are considered in more severe cases. The disease lasts for around one to four months. The neurological complications include cerebellar ataxia, meningoencephalitis, and aseptic meningitis. Here, we describe the case of a 36-year-old male who presented with complaints of fever, malaise chills, anorexia, and fatigue associated with a tender right axillary lymph node. The patient underwent a biopsy which confirmed KFD and responded well to supportive therapy.
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Affiliation(s)
- Abeer Qasim
- Internal Medicine, BronxCare Health System, Bronx, USA
| | - Vikram Itare
- Internal Medicine, BronxCare Health System, Bronx, USA
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4
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Muacevic A, Adler JR. Kikuchi's Disease Diagnosed by an Excisional Biopsy in a Patient With COVID-19. Cureus 2023; 15:e35251. [PMID: 36825075 PMCID: PMC9942247 DOI: 10.7759/cureus.35251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 02/23/2023] Open
Abstract
COVID-19 is an ongoing pandemic caused by the novel coronavirus SARS-CoV-2. The clinical features of COVID-19 are myriad. Though it is a multisystem illness, it predominantly involves the respiratory system. There have been case reports on rare manifestations of COVID-19, of which COVID-19-related Kikuchi's disease is one of them. To our knowledge, this is the third reported case in the world. We report a lady in her late 60s with COVID-19 infection and secondary bacterial pneumonia, which necessitated ICU admission, having ongoing fever spikes with high inflammatory markers and leukopenia. She was also found to have tender cervical lymphadenopathy on the third week of illness, whose biopsy revealed histiocytic necrotizing lymphadenitis in keeping with Kikuchi's disease. The patient had an uneventful recovery in two weeks without any intervention. The pathophysiology of COVID-19-related Kikuchi's disease is unclear. However, COVID-19 is a viral illness that involves changes in interleukins. The latter is postulated in Kikuchi's disease.
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Fadul A, Subahi EA, Ali EA, Awadalkareem H, Mohamed G, Elawad M, Sharaf Eldean M, Albozom A. Kikuchi-Fujimoto Disease: A Rare Cause of Pyrexia of Unknown Origin and Cervical Lymphadenopathy. Cureus 2022; 14:e30823. [DOI: 10.7759/cureus.30823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
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6
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Gism Elseed I, Osman H, Ahmedfiqi O, Najmi F, Al-Hebshi A. Kikuchi-Fujimoto Disease: A Rare Benign Cause of Lymphadenopathy That Mimics Malignant Lymphoma. Cureus 2022; 14:e23177. [PMID: 35444918 PMCID: PMC9009272 DOI: 10.7759/cureus.23177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/05/2022] Open
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7
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Fiori M, Spina P, Monotti R, Salvadé I. Abdominal Kikuchi-Fujimoto lymphadenopathy: an uncommon presentation of a rare disease. BMJ Case Rep 2022; 15:e244732. [PMID: 35210223 PMCID: PMC8883202 DOI: 10.1136/bcr-2021-244732] [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] [Indexed: 11/04/2022] Open
Abstract
A 34-year-old man presented to our hospital with a 5-day history of progressive abdominal pain and fever. A CT scan identified extensive mesenteric lymphadenopathy. Initial diagnostic tests were inconclusive. Abdominal lymph node biopsy showed histiocytic necrotising lymphadenitis, compatible with Kikuchi-Fujimoto disease (KFD). This benign and self-limiting disease generally resolves following supportive treatment. In this case, remission occurred within 3 weeks of initial presentation. KFD is a very uncommon cause of lymphadenopathy, and selective mesenteric involvement is rare. Definitive diagnosis often requires lymph node biopsy. It is important to exclude more common and serious differential diagnoses associated with mesenteric lymphadenopathy, while maintaining a minimally invasive diagnostic approach, before progressing to nodal biopsy.
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Affiliation(s)
- Marco Fiori
- Internal Medicine, EOC, Bellinzona, Switzerland
| | - Paolo Spina
- Cantonal Institute of Pathology, EOC, Bellinzona, Switzerland
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8
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Al Ghadeer HA, AlKadhem SM, AlMajed MS, AlAmer HM, AlHabeeb JA, Alomran SH, AlMajed AS. Kikuchi-Fujimoto Disease Following COVID-19. Cureus 2022; 14:e21049. [PMID: 35155016 PMCID: PMC8824308 DOI: 10.7759/cureus.21049] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/05/2022] Open
Abstract
Kikuchi-Fujimoto Disease (KFD) is a rare self-limiting condition of unknown etiology. It is characterized by fever, and lymphadenopathy most commonly involving posterior cervical lymph nodes. Although it is of uncertain etiology, it is associated with viral infections and autoimmune diseases. Distinction from lymphadenopathy-associated alternate disorders is crucial to avoid unneeded diagnostic procedures and treatment. KFD is diagnosed based on histopathologic examination of the excised lymph node. The management is supportive with favorable outcomes within a few weeks or months. In this case, we describe a 13-year-old boy who complained of painful cervical lymphadenopathy and fever for more than three weeks following COVID-19. Diagnostic workup has been established and KFD diagnosis made based on the histopathologic features of the involved lymph node. The patient showed complete recovery with no recurrence during follow-up. So, this case highlights the possible association between COVID-19 and KFD during this pandemic and keeping it in the differential diagnosis.
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9
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Khan AM, Ahmad M, Muhammad O, Taj S, Shiza ST. Kikuchi-Fujimoto Disease in a Young Female: A Case Report and Literature Review. Cureus 2021; 13:e19321. [PMID: 34900492 PMCID: PMC8649112 DOI: 10.7759/cureus.19321] [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: 11/06/2021] [Indexed: 11/25/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is histiocytic necrotizing lymphadenitis, a rare immune-mediated disorder presenting with lymphadenopathy, leukopenia, and occasionally fever. Herein we report a case of KFD who presented with anorexia, fever, and cervical lymphadenopathy. Lymph node biopsy and immunohistochemistry confirmed the diagnosis of KFD. She was treated with prednisolone and paracetamol, and her condition improved gradually on subsequent follow-up. A patient presenting with fever and lymphadenopathy leads to prompt investigations for common diseases such as tuberculosis and lymphoma. However, rare diseases like KFD must be kept in mind, and a lymph node biopsy followed by histopathologic examination and immunohistochemistry should be done to confirm the diagnosis.
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Affiliation(s)
- Aadil M Khan
- Internal Medicine, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND
| | - Moinuddin Ahmad
- Internal Medicine, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND
| | - Owaise Muhammad
- General Medicine, Lugansk State Medical University, Kyiv, UKR
| | - Shafaq Taj
- Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND
| | - Saher T Shiza
- Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND
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Hoan L, Minh Hang L, Tuan Linh L, Thi Tra My T, Ngoc Minh T, Duc Thinh D, Ngoc Cuong N. A Rare Case of Kikuchi-Fujimoto Disease in a Young Female Patient. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e933377. [PMID: 34802030 PMCID: PMC8614063 DOI: 10.12659/ajcr.933377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patient: Female, 25-year-old
Final Diagnosis: Kikuchi-Fujimoto disease
Symptoms: Neck pain • palpable mass neck
Medication: —
Clinical Procedure: —
Specialty: Pathology • Pulmonology • Radiology
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Affiliation(s)
- Le Hoan
- Department of Respiratory Medicine, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Le Minh Hang
- Department of Respiratory Medicine, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Le Tuan Linh
- Diagnostic Imaging and Interventional Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Thieu Thi Tra My
- Diagnostic Imaging and Interventional Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Tran Ngoc Minh
- Department of Pathology, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Dang Duc Thinh
- Department of Pathology, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Nguyen Ngoc Cuong
- Diagnostic Imaging and Interventional Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam
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11
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YILDIRIM S, AŞIK A, ÇOBANOĞLU ŞİMŞEK B, BOZKURT A. Case report: Kikuchi-Fujimoto disease or lymphoma? KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.900042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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12
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Fauzi LS, Unadkat V, Abd Hadi SNB, Rinaldi C. Case of Kikuchi-Fujimoto disease associated with multiple myeloma. BMJ Case Rep 2021; 14:14/5/e241391. [PMID: 34016631 DOI: 10.1136/bcr-2020-241391] [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] [Indexed: 11/04/2022] Open
Abstract
We present a 47-year-old, South-African origin, woman with a background of stable monoclonal gammopathy of unknown significance (MGUS) who attended A&E with a history of coryzal symptoms associated with persistent fever, lymphadenopathy and a new onset of rash, not responding to antibiotics and paracetamol. A trial of high-dose steroids resolved symptoms. Bone marrow biopsy confirmed a progression of MGUS into multiple myeloma and her axillary lymph node biopsy analysis supported a diagnosis of Kikuchi-Fujimoto disease (KFD). This is an unusual presentation where KFD has been noted alongside MGUS progression to multiple myeloma. Haematology follow-up is underway.
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Affiliation(s)
| | - Vidhi Unadkat
- Internal Medicine, Pilgrim Hospital, Boston, Lincolnshire, UK
| | | | - Ciro Rinaldi
- Department of Haematology, Pilgrim Hospital, Boston, Lincolnshire, UK
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13
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Jaseb K, Nameh Goshay Fard N, Rezaei N, Sadeghian S, Sadeghian S. COVID-19 in a case with Kikuchi-Fujimoto disease. Clin Case Rep 2021; 9:1279-1282. [PMID: 33768826 PMCID: PMC7981657 DOI: 10.1002/ccr3.3748] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/05/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022] Open
Abstract
The accurate diagnosis of Kikuchi-Fujimoto disease can protect children from unnecessary diagnostic procedures and treatments. Also, the co-occurrence of rare diseases with other diseases can improve or worsen the symptoms of the patients.
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Affiliation(s)
- Kaveh Jaseb
- Thalassemia & Hemoglobinopathy Research CenterHealth Research InstituteAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Najmeh Nameh Goshay Fard
- Thalassemia & Hemoglobinopathy Research CenterHealth Research InstituteAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children’s Medical CenterTehran University of Medical SciencesTehranIran
- Department of Immunology, School of MedicineTehran University of Medical SciencesTehranIran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA)Universal Scientific Education and Research Network (USERN)TehranIran
| | | | - Saeid Sadeghian
- Department of Paediatric Neurology, Golestan Medical, Educational, and Research CentreAhvaz Jundishapur University of Medical SciencesAhvazIran
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14
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Boochoon KS, Barbieri AN, Mohyuddin NG. An Abnormal Neck Mass in a Pediatric Patient. JAMA Otolaryngol Head Neck Surg 2021; 146:375-376. [PMID: 31944256 DOI: 10.1001/jamaoto.2019.4339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Andreia N Barbieri
- Weill Cornell Medicine, Institute of Academic Medicine, Department of Pathology, Houston Methodist Hospital, Houston Texas
| | - Nadia G Mohyuddin
- Weill Cornell Medicine, Institute for Academic Medicine, Houston Methodist ENT Specialists, Houston, Texas.,Department of Surgery, Texas A&M College of Medicine, Houston
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15
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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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16
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Faheem B, Kumar V, Ashkar H, Komal F, Sultana Y. Recurrent Kikuchi-Fujimoto Disease Masquerading as Lymphoma Successfully Treated by Anakinra. Cureus 2020; 12:e11655. [PMID: 33391894 PMCID: PMC7769493 DOI: 10.7759/cureus.11655] [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] [Indexed: 12/27/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare and benign disease that usually presents in middle-aged women of Oriental-Asian ethnicity. This condition was described in Japan for the first time in 1972. Though the clinical course is benign, KFD has been misdiagnosed as malignancy (e.g. lymphoma) or infection. The most common presentation of KFD is with localized or generalized lymphadenopathy, fever, fatigue, weight loss, hepatosplenomegaly, and rash. A definitive diagnosis of KFD can be made by excisional lymph node biopsy, as immunohistochemical analysis is necessary. We present here an interesting case of a 20-year-old Hispanic female who was diagnosed with KFD who failed therapy with steroids and was subsequently treated successfully with the interleukin-1 (IL-1) inhibitor - anakinra.
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Affiliation(s)
- Beenish Faheem
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Vinod Kumar
- Oncology, St. Joseph's University Medical Center, Paterson, USA
| | - Hamdallah Ashkar
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Fnu Komal
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Yasmeen Sultana
- Hematology/Oncology, St. Joseph's University Medical Center, Paterson, USA
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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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18
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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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