Kikuchi-Fujimoto disease: three case reports

Abstract

CONTEXT: Kikuchi-Fujimoto disease (KFD) manifests in most cases as unilateral cervical lymphadenomegaly, with or without accompanying fever.The disease mainly affects young women and has a self-limited course. It is more common in oriental countries, with few reports of its occurrence in Brazil. KFD should be included in the differential diagnosis of suspected cases of viral infections, tuberculosis, reactive lymphadenitis, systemic lupus erythematosus and metastatic diseases. It can be histologically confused with lymphoma. The disease is benign and self-limiting and an excisional biopsy of an affected lymph node is necessary for diagnosis. There is no specific therapy. CASE REPORTS:This study reports on three cases of non-Asian female patients with KFD who were attended at our service between 2003 and 2006. A review of the literature was carried out, with a systematic search on this topic, with the aim of informing physicians about this entity that is manifested by cervical masses and fever.RESUMO CONTEXTO: A doença de Kikuchi-Fujimoto (DKF) se manifesta na maioria das vezes como linfadenomegalia cervical unilateral, que pode ser acompanhada de febre. Afeta principalmente mulheres jovens, com evolução autolimitada. A prevalência desta doença é mais comum no oriente, havendo poucos relatos de sua ocorrência em nosso meio. DKF deve ser incluída no diagnóstico diferencial de casos suspeitos de infecções por vírus, tuberculose, linfadenite reacional, lúpus eritematoso sistêmico e doença metastática. Histologicamente pode ser confundida com linfoma. A doença é de caráter benigno, auto-limitada, a biópsia excisional do linfonodo acometido é necessária para o diagnóstico e não há tratamento específico. RELATO DE CASOS:Este trabalho relata três casos de pacientes não asiáticas do sexo feminino com DKF, atendidas em nosso serviço entre 2003 e 2006, e faz revisão da literatura com uma busca sistematizada sobre o assunto, com o objetivo de informar os médicos sobre essa entidade que se manifesta com massa cervical e febre.

A polymorphic challenge

“…In the herein reported patient the association of lymph node enlargement and a limited spectrum of rheumatologic signs (arthritis, leukopenia, Raynaud's phenomenon, and positive autoimmune serology) favored the diagnosis of KFD. Moreover, in contrast with other reports of KFD which were excluding SLE [16][17] , in the present case the clinical and, mostly, serological signs of an active SLE were markedly evident. Interestingly such clinical presentation (with marked signs of inflammatory activity) and the presence of a diffuse pattern of lymph node involvement seem to be almost invariably reported in SLE-KFD associations [5,18] .…”

Kikuchi Fujimoto disease

“…10 EBV infections are also found in connection with Burkitt's lymphoma and naso-pharyngeal carcinoma. 11 In our patient EBV(VCA)-IgG, (Abs to Viral Capsid Ag) 1:10 by IF (Indirect Imunofluorescence) positive. Determination of avidity is an established method for reliable identification of primary infections.…”

Kikuchi Fujimoto Disease: The First Reported Case in Mongolia

“…The etiopathogenesis of KFD has not been fully elucidated, but the literature suggests viral and bacterial infections, including toxoplasma, human herpes virus 6 and 8, Epstein-Barr virus, parvovirus B-19, HIV, human T-cell lymphotropic virus, cytomegalovirus, Yersinia enterocolitica, Bartonella and Brucella; or possibly autoimmune components to play a role [9,10]. Since 2010, researchers have performed many molecular genetic experiments to elucidate the pathogenesis of this disorder.…”