Kikuchi-fujimoto disease: a case report

Kikuchi-Fujimoto disease is a self-limiting lymphadenitis rarely presents outside Japan and is usually noted during the evaluation of lymphadenopathy We report a case of a 23-year-old female who presented with fever of unknown origin and splenomegaly for three weeks. The patient underwent numerous investigations and was suspected of having malignant lymphoma. Her follow-up physical examination revealed cervical and inguinal lymphadenopathy. The histopathological report of the lymph node biopsy was consistent with Kikuchi - Fujimoto disease. Splenomegaly, and lymphadenopathy resolved spontaneously after two months and the patient has been well ever since with strict follow-up for seven years

Anticoagulation period in idiopathic venous thromboembolism. How long is enough?

The period of anticoagulation of a first episode of idiopathic venous thromboembolism has been 6 months. It is unclear if such patients would benefit from longer treatment, as there appears to be an increased risk of recurrence after anticoagulation is stopped. In a randomized prospective study of 64 patients admitted to King Hussein Medical city, Amman, Jordan, who developed a first episode of venous thromboembolism, 32 patients were given warfarin for 24-months, while 32 patients stopped anticoagulation after completion of 6-months of therapy. Our goal was to determine the effects of extended anticoagulation on rates of recurrence of symptomatic venous thromboembolism and bleeding. The patients were followed for 12-months after stopping anticoagulation. After 24-months, 7 of the 32 patients [21%] who had standard anticoagulation for 6-months had a recurrent episode of thromboembolism compared to one of the 32 patients who received anticoagulation for 24 months [3%]. Extended warfarin therapy for 24-months has resulted in an absolute risk reduction of 0.1% [p<0.05]. This translates into 8 patients having to be treated for 24-months to avoid one recurrence without increasing the risk of major bleeding. Two patients in each group [6%] had major nonfatal bleeding, all 4 bleeding episodes occurring within the first 3-months of anticoagulation. After 36-months of follow up, the recurrence rate of extended warfarin therapy was only 3 patients [9%], which is a 43% relative reduction in recurrence of thromboembolism compared to standard therapy for 6-months. Patients with first episodes of idiopathic venous thromboembolism have an increased risk of recurrent venous thromboembolism and should be treated with oral anticoagulants for longer than 6-months, probably 24-months