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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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Chong Y, Lee JY, Thakur N, Kang CS, Lee EJ. Strong association of Torque teno virus/Torque teno-like minivirus to Kikuchi-Fujimoto lymphadenitis (histiocytic necrotizing lymphadenitis) on quantitative analysis. Clin Rheumatol 2019; 39:925-931. [PMID: 31782015 DOI: 10.1007/s10067-019-04851-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 09/06/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Kikuchi-Fujimoto disease (KFD) is a rare benign lymphadenitis that mainly involves cervical lymph nodes of young Asian women with unknown etiology. Recently, we experienced a case of KFD found with Torque teno virus/Torque teno-like mini virus (TTV/TTMV) from a 26-year-old woman. TTV/TTMV is a genus of Circoviridae that causes necrotizing lymphadenitis in pigs, which shares the key histologic finding of KFD. The purpose of this study is to investigate the pathogenic role of TTV/TTMV in KFD by quantitative polymerase chain reaction (qPCR) analysis. METHOD We performed two-step qPCR specific to TTV/TTMV with formalin-fixed paraffin-embedded tissue of sequentially selected 100 KFD patients and 50 randomly selected, matched normal controls. Consequent direct sequencing was done for confirmation with PCR products. RESULTS PCR amplification of TTV and TTMV was found in a significantly higher proportion in KFDs than normal controls (TTV, 85% vs. 18%, p < 0.000; TTMV, 91% vs. 24%, p < 0.000). After the sequencing, KFD samples showed more sequence matching than control samples for TTMV (94% vs. 30%, p < 0.000). CONCLUSION This finding strongly suggests the possible implication of TTV/TTMV in the pathogenesis of KFD. Animal or in vivo experimental design should be followed in the future.Key Points• Kikuchi-Fujimoto disease (KFD) is rare and its etiology is still unclear.• Torque teno/Torque teno-like minivirus (TTV/TTMV) is a recently introduced virus in the Circoviridae family that causes necrotizing lymphadenitis in pigs, histologically similar to KFD.• We discovered the significantly increased TTV/TTMV viral loads in the KFD patients than normal controls, which implicates TTV/TTMV in the pathogenesis of KFD.
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Affiliation(s)
- Yosep Chong
- Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea.
| | - Ji Young Lee
- Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Nishant Thakur
- Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Chang Suk Kang
- Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea.,Department of Pathology, Samkwang Medical Laboratories, 57, Baumoe-ro 41-gil, Seocho-gu, Seoul, 06742, Republic of Korea
| | - Eun Jung Lee
- Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
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Ozen ME, Orum MH, Kalenderoglu A, Atmaca M. Improvement of an atypical Kikuchi-Fujimoto disease (KFD) with antidepressant treatment: the first psychiatric approach to a KFD case. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2018.1431352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Mehmet Hamdi Orum
- Department of Psychiatry, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
| | - Aysun Kalenderoglu
- Department of Psychiatry, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
| | - Murad Atmaca
- Department of Psychiatry, Firat University Faculty of Medicine, Elazig, Turkey
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Dalugama C, Gawarammana IB. Fever with lymphadenopathy - Kikuchi Fujimoto disease, a great masquerader: a case report. J Med Case Rep 2017; 11:349. [PMID: 29246252 PMCID: PMC5732422 DOI: 10.1186/s13256-017-1521-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/20/2017] [Indexed: 12/05/2022] Open
Abstract
Background Kikuchi Fujimoto disease is an uncommon benign condition of necrotizing histiocytic lymphadenitis commonly seen in East Asian and Japanese populations. It commonly presents with fever, cervical lymphadenopathy, and elevated inflammatory markers. Diagnosis of Kikuchi Fujimoto disease is based on histopathological studies of the involved lymph nodes. The presentation of Kikuchi Fujimoto disease can mimic many sinister conditions including lymphoma. Treatment is mainly supportive provided that accurate diagnosis is made and sinister conditions like lymphoma ruled out. Case presentation We report the case of an 18-year-old Sri Lankan Moor woman who presented with fever and cervical lymphadenopathy for 1 month. She had elevated inflammatory markers with high lactate dehydrogenase and ferritin levels. She had an extensive work-up including an excision biopsy of an involved lymph node and bone marrow biopsy. Finally, a diagnosis of Kikuchi Fujimoto disease was based on histopathology of the lymph node and negative bone marrow biopsy. Conclusions Although Kikuchi Fujimoto disease is a self-limiting condition, it is a great masquerader which mimics the clinical features of many sinister conditions including tuberculosis, lymphoma, and adult-onset Still’s disease. Early recognition of the disease is of crucial importance in minimizing potentially harmful and unnecessary evaluations and treatments.
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Affiliation(s)
- Chamara Dalugama
- Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
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Kataria R, Rao P, Kachhawa D, Jain VK, Tuteja RK, Vijayvargiya M. Kikuchi-Fujimoto Disease, the Masquerading Menace: A Rare Case Report. Indian J Dermatol 2016; 61:348. [PMID: 27293275 PMCID: PMC4885208 DOI: 10.4103/0019-5154.182465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis is a rare, benign, self-limiting disease with unknown etiology characterized by regional lymphadenopathy. A 30-year-old female presented with fever, weakness, multiple joint pain, oral ulcers, erythematous facial rashes, hemorrhagic crusting on both lips, and cervical lymphadenopathy of 2-month duration. Clinically, the disease was mimicking systemic lupus erythematosus, but immunofluorescence was negative for it. Lymph node biopsy suggested a diagnosis of KFD.
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Affiliation(s)
- Rohit Kataria
- Department of Dermatology and Venereology, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Pankaj Rao
- Department of Dermatology and Venereology, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Dilip Kachhawa
- Department of Dermatology and Venereology, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Vinod K Jain
- Department of Dermatology and Venereology, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Rajat K Tuteja
- Department of Medicine, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
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Martins SS, Buscatti IM, Freire PS, Cavalcante EG, Sallum AM, Campos LMA, Silva CA. [Kikuchi-Fujimoto disease prior to childhood-systemic lupus erythematosus diagnosis]. REVISTA BRASILEIRA DE REUMATOLOGIA 2014; 54:400-3. [PMID: 25627306 DOI: 10.1016/j.rbr.2013.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 03/01/2013] [Accepted: 03/21/2013] [Indexed: 02/04/2023] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a self-limiting histiocytic necrotizing lymphadenitis of unknown origin. Of note, KFD was infrequently reported in adult systemic lupus erythematosus (SLE), with rare occurrence in childhood-SLE (C-SLE) patients. To our knowledge, the prevalence of KFD in the paediatric lupus population was not studied. Therefore, in a period of 29 consecutive years, 5,682 patients were followed at our institution and 289 (5%) met the American College of Rheumatology classification criteria for SLE, one had isolated KFD (0.03) and only one had KFD associated to C-SLE diagnoses, which case was reported herein. A 12 year-old female patient had high fever, fatigue and cervical and axillary lymphadenopathy. The antinuclear antibodies (ANA) were negative, with positive IgM and IgG herpes simplex virus type 1 and type 2 serologies. Fluorine-18-fluoro-deoxy-glucose positron emission tomography/computed tomography (PET/CT) imaging demonstrated diffuse lymphadenopathy. The axillary lymph node biopsy showed necrotizing lymphadenitis with histiocytes, without lymphoproliferative disease, compatible with KFD. After 30 days, she presented spontaneous regression and no therapy was required. Nine months later, she developed malar rash, photosensitivity, oral ulcers, lymphopenia and ANA 1:320 (homogeneous nuclear pattern). At that moment the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score was 10 and she was treated with prednisone (1.0mg/kg/day) and hidroxychloroquine showing progressive improvement of hers signs and symptoms. In conclusion, KFD is a benign and rare disease in our paediatric lupus population. We also would like to reinforce the relevance of autoimmune diseases diagnosis during the follow-up of patients with KFD.
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Affiliation(s)
- Sofia S Martins
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil
| | - Izabel M Buscatti
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil
| | - Pricilla S Freire
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil
| | - Erica G Cavalcante
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil
| | - Adriana M Sallum
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil
| | - Lucia M A Campos
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil
| | - Clovis A Silva
- Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil; Divisão de Reumatologia, Faculdade de Medicina, Universidade São Paulo, São Paulo, SP, Brasil.
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The enigmatic kikuchi-fujimoto disease: a case report and review. Case Rep Hematol 2014; 2014:648136. [PMID: 24649384 PMCID: PMC3932818 DOI: 10.1155/2014/648136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 12/29/2013] [Indexed: 01/16/2023] Open
Abstract
We report this case of a 33-year-old African American woman who presented to the clinic with preauricular and submandibular masses that she had noticed 6 weeks earlier. She gave a remote history of noticing bilateral cervical masses 3 years prior to this presentation that had not been investigated at the time and resolved spontaneously. Excisional biopsies of the cervical lymph nodes showed morphologic and immunophenotypic findings suggestive of Kikuchi Fujimoto disease (KFD). KFD is an uncommon, self-limited, and perhaps an underdiagnosed entity with an excellent prognosis. It mimics malignant lymphoma in presentation and therefore an accurate clinicopathological differentiation is crucial.
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Abstract
Kikuchi-Fujimoto disease, characterized by histiocytic necrotizing lymphadenitis, closely mimics tuberculosis, and lymphoma are two most common etiologies of cervical lymphadenitis. It is a rare, benign, and self-limited disease. Viral infections or autoimmunity are hypothesized as its etiology, but no causal relationship is definitely established till date. No specific treatment is available, only supportive treatment is given. Here, we represent a rare case of Kikuchi's disease in a 29-year-old male patient who presented to us with right-sided posterior cervical lymphadenopathy with low-grade fever for three months.
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Affiliation(s)
- Sudipta Pandit
- Department of Chest Medicine, Medical College, Kolkata, India
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Patra A, Bhattacharya SK. SLE Developing in a Follow-Up Patient of Kikuchi's Disease: A Rare Disorder. J Clin Diagn Res 2013; 7:752-3. [PMID: 23730669 DOI: 10.7860/jcdr/2013/5017.2904] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 12/10/2012] [Indexed: 11/24/2022]
Abstract
Kikuchi's disease or the Kikuchi-Fujimoto Disease (KFD) is a very rare, self-limiting, benign form of histiocytic necrotizing lymphadenitis, which is mostly seen in young females. We are presenting a case of Systemic Lupus Erythematosus (SLE) which occurred after 2 years in a patient of Kikuchi's disease during a follow-up examination.
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Affiliation(s)
- Anupam Patra
- Post Graduate Trainee, Respiratory Medicine, Nilratan Sircar Medical College , Kolkata, India
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