Kikuchi-Fujimoto disease: pediatric case presentation
Keywords:
Histiocytic necrotizing lymphadenitis, lymphatic diseases, herpesvirus 4, human, lupus erythematosus, systemic, fever
Abstract
Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a rare, benign condition, usually self-limited to a six-month period. Classic clinical presentation is characterized by cervicallymphadenopathy, leukopenia and prolonged fever. It affects principally young, Asiatic adult women, although a few cases in the pediatric population have been reported. This disease frequently mimics
tuberculous lymphadenitis, malign lymphoma, systemic lupus erythematosus and other benign and malignant conditions. The etiology is unknown, although a viral or autoimmune pathogenesis has been suggested. Laboratory investigations are usually unremarkable, and the most frequent findings are leukopenia, elevated erythrocyte sedimentation rate, anemia and positive antinuclear antibodies. To
make an accurate diagnosis, histopathological studies are required. To avoid the use of antibiotics (which have no effect), early diagnosis is necessary. Herein the case of a 10 years old girl is described that presented with high, prolonged fever and marked cervical lymphadenopathy secondary to Kikuchi-Fujimoto disease.
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References
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2. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytosis. Nippon Ketsueki Gakkai Zasshi. 1972;35:379-80.
3. Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis. A new clinicopathologic agent. Naika. 1972;30:920-7.
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5. Famularo G, Giustiniani MC, Marasco A, Minisola G, Nicotra GC, De Simone C. Kikuchi Fujimoto lymphadenitis: Case report and literature review. Am J Hematol. 2003;74:60-3.
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7. Cunha BA, Mickail N, Durie N, Pherez FM, Strollo S. Fever of unknown origin (FUO) caused by Kikuchi's disease mimicking lymphoma Heart Lung. 2009;38:450-6.
8. Sumiyoshi Y, Kikuchi M, Minematu T. Analysis of herpesvirus genomes in Kikuchi's disease. Virchows Arch. 1994;424:437-40.
9. Zhang WP, Wang JH, Wang WQ, Wang Z, Chen XQ, Li YF, et al. An association between parvovirus B19 and Kikuchi-Fujimoto disease. Viral Immunol. 2007;20:421-8.
10. PayneJ.H, Evans M, Gerrard MP. Kikuchi-Fujimoto disease: a rare but important cause of lymphadenopathy. Acta Paediatr. 2003;92:261-4.
11. Bosch X, Guilabert A. Kikuchi-Fujimoto disease. Orphanet J Rare Dis. 2006;1:1-3.
12. Lazzareschi I, Barone G, Ruggiero A, Liotti L, Maurizi P, Larocca LM, et al. Paediatric Kikuchi-Fujimoto disease: A benign cause of fever and lymphadenopathy. Pediatr Blood Cancer. 2008;50:119-23.
13. Bosch X, Guilabert A, Miquel R, Campo E. Enigmatic Kikuchi-Fujimoto disease. A comprehensive review. Am J Clin Pathol. 2004;122:141-52.
14. Vassilakopoulos TP, Pangalis GA, Siakantaris MP, Levidou G, Yiakoumis X, Floudas C, et al. Kikuchi's lymphadenopathy: A relatively rare but important cause of lymphadenopathy in Greece, potentially associated with the antiphospholipid syndrome. Rheumatol Int. 2010;30:925-32.
15. García CE, Girdhar-Gopal HV, Dorfman DM. Kikuchi-Fujimoto disease of the neck. Update. Ann Otol Rhinol Laryngol. 1993;102:11-5.
16. Kuo Tseng-tong. A clinicopathologic study of 79 cases with an analysis of histologic subtypes, immunohistology, and DNA ploidy. Am J Surg Pathol. 1995;19:798-809.
17. Cramer JP, Schmiedel S, Alegre NG, Schäfer H, Burchard GD, Merz H. Necrotizing lymphadenitis: Kikuchi-Fujimoto disease alias lupus lymphadenitis? Lupus. 2010;19:89-92.
18. Martínez C, Hughes G, Bordon J, Alonso J, Anibarro A, Redondo E, et al. Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto's disease, associated with systemic lupus erythematosus. QJM. 1997;90:531-3.
19. Santana A, Lessa B, Galrao L, Lima I, Santiago M. Kikuchi-Fujimoto's disease associated with systemic lupus erythematosus: Case report and review of the literature. Clin Rheumatol. 2005;24:60-3.
20. Dubois EL, Tuffanelli DL. Clinical manifestations of systemic lupus erythematosus. Computer analysis of 520 cases. JAMA. 1964;190:1014-111.
21. Meislin AG, Rothfield N. Systemic lupus erythematosus in childhood. Analysis of 42 cases, with comparative data on 200 adult cases followed concurrently. Pediatrics. 1968;42:37-49.
22. Shiokawa S, Yasuda M, Kikuchi M, Yoshikawa Y, Nobunaga M. Mixed connective tissue disease associated with lupus lymphadenitis. J Rheumatol. 1993;120:147-50.
23. Medeiros LJ, Kaynor B, Harris NL. Lupus lymphadenitis: Report of a case with immunohistologic studies on frozen sections. Hum Pathol. 1989;120:295-9.
24. Kojima M, Motoori T, Asano S, Nakamura S. Histological diversity of reactive and atypical proliferative lymph node lesions in systemic lupus erythematosus patients. Pathol Res Pract. 2007;203:423-31.
25. Kojima M, Nakamura S, Morishita Y, Itoh H, Yoshida K, Ohno Y, et al. Reactive follycular hyperplasia in the lymph node lesions from systemic lupus erythematosus patients: A clinicopathological and immunolohistological study of 21 cases. Pathol Int. 2000;50:304-12.
26. Tsang W, Chan J. Kikuchi's lymphadenitis: A morphologic analysis of 75 cases with special reference to unusual features. Am J Surg Pathol. 1994;18:219-31.
27. Lin HC, Su CY, Huang CC, Hwang CF, Chien CY. Kikuchi's disease: A review and analysis of 61 cases. Otolaryngol Head Neck Surg. 2003;128:650-3.
2. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytosis. Nippon Ketsueki Gakkai Zasshi. 1972;35:379-80.
3. Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis. A new clinicopathologic agent. Naika. 1972;30:920-7.
4. Lee KY, Yeon YH, Lee BC. Kikuchi-Fujimoto disease with prolonged fever in children. Pediatrics. 2004;114:752-6.
5. Famularo G, Giustiniani MC, Marasco A, Minisola G, Nicotra GC, De Simone C. Kikuchi Fujimoto lymphadenitis: Case report and literature review. Am J Hematol. 2003;74:60-3.
6. Kampitak T. Fatal Kikuchi-Fujimoto disease associated with SLE and hemophagocytic syndrome: A case report. Clin Rheumatol. 2008;27:1073-5.
7. Cunha BA, Mickail N, Durie N, Pherez FM, Strollo S. Fever of unknown origin (FUO) caused by Kikuchi's disease mimicking lymphoma Heart Lung. 2009;38:450-6.
8. Sumiyoshi Y, Kikuchi M, Minematu T. Analysis of herpesvirus genomes in Kikuchi's disease. Virchows Arch. 1994;424:437-40.
9. Zhang WP, Wang JH, Wang WQ, Wang Z, Chen XQ, Li YF, et al. An association between parvovirus B19 and Kikuchi-Fujimoto disease. Viral Immunol. 2007;20:421-8.
10. PayneJ.H, Evans M, Gerrard MP. Kikuchi-Fujimoto disease: a rare but important cause of lymphadenopathy. Acta Paediatr. 2003;92:261-4.
11. Bosch X, Guilabert A. Kikuchi-Fujimoto disease. Orphanet J Rare Dis. 2006;1:1-3.
12. Lazzareschi I, Barone G, Ruggiero A, Liotti L, Maurizi P, Larocca LM, et al. Paediatric Kikuchi-Fujimoto disease: A benign cause of fever and lymphadenopathy. Pediatr Blood Cancer. 2008;50:119-23.
13. Bosch X, Guilabert A, Miquel R, Campo E. Enigmatic Kikuchi-Fujimoto disease. A comprehensive review. Am J Clin Pathol. 2004;122:141-52.
14. Vassilakopoulos TP, Pangalis GA, Siakantaris MP, Levidou G, Yiakoumis X, Floudas C, et al. Kikuchi's lymphadenopathy: A relatively rare but important cause of lymphadenopathy in Greece, potentially associated with the antiphospholipid syndrome. Rheumatol Int. 2010;30:925-32.
15. García CE, Girdhar-Gopal HV, Dorfman DM. Kikuchi-Fujimoto disease of the neck. Update. Ann Otol Rhinol Laryngol. 1993;102:11-5.
16. Kuo Tseng-tong. A clinicopathologic study of 79 cases with an analysis of histologic subtypes, immunohistology, and DNA ploidy. Am J Surg Pathol. 1995;19:798-809.
17. Cramer JP, Schmiedel S, Alegre NG, Schäfer H, Burchard GD, Merz H. Necrotizing lymphadenitis: Kikuchi-Fujimoto disease alias lupus lymphadenitis? Lupus. 2010;19:89-92.
18. Martínez C, Hughes G, Bordon J, Alonso J, Anibarro A, Redondo E, et al. Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto's disease, associated with systemic lupus erythematosus. QJM. 1997;90:531-3.
19. Santana A, Lessa B, Galrao L, Lima I, Santiago M. Kikuchi-Fujimoto's disease associated with systemic lupus erythematosus: Case report and review of the literature. Clin Rheumatol. 2005;24:60-3.
20. Dubois EL, Tuffanelli DL. Clinical manifestations of systemic lupus erythematosus. Computer analysis of 520 cases. JAMA. 1964;190:1014-111.
21. Meislin AG, Rothfield N. Systemic lupus erythematosus in childhood. Analysis of 42 cases, with comparative data on 200 adult cases followed concurrently. Pediatrics. 1968;42:37-49.
22. Shiokawa S, Yasuda M, Kikuchi M, Yoshikawa Y, Nobunaga M. Mixed connective tissue disease associated with lupus lymphadenitis. J Rheumatol. 1993;120:147-50.
23. Medeiros LJ, Kaynor B, Harris NL. Lupus lymphadenitis: Report of a case with immunohistologic studies on frozen sections. Hum Pathol. 1989;120:295-9.
24. Kojima M, Motoori T, Asano S, Nakamura S. Histological diversity of reactive and atypical proliferative lymph node lesions in systemic lupus erythematosus patients. Pathol Res Pract. 2007;203:423-31.
25. Kojima M, Nakamura S, Morishita Y, Itoh H, Yoshida K, Ohno Y, et al. Reactive follycular hyperplasia in the lymph node lesions from systemic lupus erythematosus patients: A clinicopathological and immunolohistological study of 21 cases. Pathol Int. 2000;50:304-12.
26. Tsang W, Chan J. Kikuchi's lymphadenitis: A morphologic analysis of 75 cases with special reference to unusual features. Am J Surg Pathol. 1994;18:219-31.
27. Lin HC, Su CY, Huang CC, Hwang CF, Chien CY. Kikuchi's disease: A review and analysis of 61 cases. Otolaryngol Head Neck Surg. 2003;128:650-3.
How to Cite
1.
Gómez C, Eraso RM, Aguirre CA, Pérez M del P. Kikuchi-Fujimoto disease: pediatric case presentation. biomedica [Internet]. 2010 Dec. 1 [cited 2024 Jul. 22];30(4):465-72. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/283
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Published
2010-12-01
Issue
Section
Case presentation
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