1 and Fujimoto 2 independently reported the occurrence of necrotizing lymphadenopathy in 1972 from Japan. This benign disease usually presents with cervical lymphadenopathy in young females.3 Initial reports were confined to Japan, but subsequent cases were reported from the Indian subcontinent, 4 the Middle East 5,6 and from Europe. 7 Cases presenting with pyrexia of unknown origin (PUO), as well as with splenomegaly 9 were reported. We are reporting a case of Kikuchi disease presenting with anemia.A 28-year-old Indian female presented at the medical outpatient's clinic of Najran General Hospital with a history of headache and giddiness. Clinical assessment and laboratory evaluation revealed a normocytic normochromic anemia. After thorough investigations, no cause for the anemia could be found. The patient was put on iron, B-complex and folic acid supplements, but without any improvement. Two months later, she returned to the ENT department with a history of swelling on the left side of the neck and low-grade fever of five days' duration. The patient had reportedly taken some antibiotics, without relief. Clinical examination revealed moderate pallor and a tender but nonerythematous swelling on the left side of the neck. There was no evidence of any inflammation on the head, neck, chest or arm. Systemic examination was normal. Investigations showed Hb 8.9 g/dL, TLC 7900, DLC polymorphs 62%, lymphocytes 30%, monocytes 5%, eosinophils and basophils 1% each, platelets 299, ESR 27 mm in the first hour, MCV 88 fL, MCHC 34, and Hct 30%. Peripheral smear showed nothing abnormal. Reticulocyte count was 1%. No spherocytes were seen, and sickling and osmotic fragility tests were normal. Indirect
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