A rare and interesting case report of Kikuchi-Fujimoto disease masquerading as tuberculosis

Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a rare benign, self-limited condition, probably genetic, that mainly affects young women which often presents with localised lymphadenopathy and fever. Reporting the case of a 17-year-old girl, with a strong family history of tuberculosis, who presented to the surgery OPD with cervical lymphadenopathy and a history of anti-tubercular treatment for the same complaints two years back. An excision biopsy revealed necrotizing histiocytic lymphadenitis suggestive of KFD. Post-operative period was uneventful and patient had spontaneous resolution of her complaints upon follow up. It is quite difficult to make a pre-operative diagnosis of this disease, until the clinician has got a very high index of suspicion especially because of the more common differential diagnoses including extrapulmonary tuberculosis.

Una relación potencialmente peligrosa: lupus eritematoso sistémico y enfermedad de Kikuchi - Fujimoto / A dangerous relation: Systemic lupus erythematosus disease and Kikuchi Fujimoto disease

Resumen La enfermedad de Kikuchi-Fujimoto (EKF) es conocida como una linfadenitis necrotizante histiocítica, tiene una presentación benigna y autolimitada, afecta principalmente a mujeres jóvenes y generalmente resuelve sin tratamiento en los primeros seis meses de los síntomas. Presentamos el caso de una mujer de 48 años quien consultó por un cuadro de dolor abdominal, mialgias y adenopatía cervical al examen físico. Se le encontró en los exámenes paraclínicos anticuerpos antinucleares 1:640, anti DNA de doble cadena asociado a consumo de complemento y anticuerpos anticardiolipina positivos. Se realizó biopsia de ganglio cervical que mostró necrosis cortical y población de histiocitos y linfocitos. Al iniciar el manejo con esteroides y cloroquina se comprobó mejoría franca y posteriormente la paciente fue dada de alta, continuando controles de manera ambulatoria por los servicios de reumatología y medicina interna.

Abstract Kikuchi disease, also known as histiocytic necrotizing lymphadenitis, isa benign and self-limited condition that mainly affects young women andresolve without treatment within six months of symptoms. It was first describedin Japan in 1972 and is more common in Asian population. We report the case of a woman of 48 years who consults for abdominal pain, myalgia, and cervical lymphadenopathy on physical examination. He found himself in the presence of antinuclear antibodies paraclinical 1: 640 positive DNA double chain associated with complement consumption and positive cardiolipin antibodies We perform cervical node biopsy that showed the presence of cortical necrosis and histiocytes and lymphocytes population. When you start handling steroid and chloroquine, a high frank and subsequent improvement was observed, continuing control rheumatology and internal medicine.

Histiocytic necrotising lymphadenitis (kikuchi's disease) [a 5 year histomorphological study].

Background: Kikuchi’s disease is a rare, benign, self-limiting disease, mainly involving the lymph nodes of young people. The disease has unknown etiology. Clinical symptoms and basic investigations in a patient often leads to a misdiagnosis, due to similar findings in other lesions like, lymphomas and chronic granulomatous inflammations of lymph nodes like tuberculosis. Lymph node biopsy shows characteristic diagnostic features. Methods: We studied all lymph node biopsies received in department of pathology & from other private laboratories in Rural and Urban areas, in & around Bareilly region of North India, in 5 years (2006-2010). Relevant clinical data was collected. Findings were correlated with previous studies. A total number of 1015 cases were examined. Results: A total of 15 cases showed histopathological features of Kikuchi’s disease. Most number of cases was seen in females, in the age group of 20-25 years. Patients presented with fever and lymphadenopathy, with a clinical provisional diagnosis of tuberculosis in maximum number of cases.Conclusion: Necrotising lymphadenitis has a striking predilection for cervical lymph nodes of females and is usually accompanied by fever. Most commonly, this disease is mistaken for tuberculosis or Lupus Lymphadenitis. Detailed clinical examination and characteristic histopathological findings help in diagnosing these lesions.