Detection of mycobacterial and viral DNA in Kikuchi-Fujimoto disease: an analysis of 153 Chinese pediatric cases

Xu, Zhe; Liu, Ying; Li, Haijing; Meng, Shumei; Boyd, Alan S.; Stratton, Charles W.; Ma, Lin; Tang, Yi‐Wei

doi:10.1007/s11427-017-9087-6

Cited by 5 publications

(5 citation statements)

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“…Viral studies, including EBV, human herpesvirus 8, parvovirus, and human herpesvirus 6, have been investigated but to no avail. 31,[46][47][48][49] Mycobacterial, bacterial, and parasite studies have also failed to identify an etiology. [49][50][51] Notably, viral studies were performed in 9 of the 14 cases in this study without positive results.…”

Section: Discussionmentioning

confidence: 99%

“…31,[46][47][48][49] Mycobacterial, bacterial, and parasite studies have also failed to identify an etiology. [49][50][51] Notably, viral studies were performed in 9 of the 14 cases in this study without positive results. Additionally, screening for Bartonella, Coxiella, Toxoplasma, Rocky Mountain Spotted Fever, Bordetella, Brucella, Tularemia, and mycobacteria were undertaken in some patients in this study and were found to be negative.…”

Section: Discussionmentioning

confidence: 99%

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A Malignant Mimicker: Features of Kikuchi-Fujimoto Disease in the Pediatric Population

et al. 2022

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Background Kikuchi-Fujimoto disease (KFD) is a rare, benign, and self-limited disease that presents with cervical lymphadenopathy and systemic symptoms. Histologic evaluation is often necessary to differentiate KFD from other entities. Methods Electronic medical records and diagnostic material were reviewed for 14 children diagnosed with KFD and 6 children diagnosed with infectious mononucleosis (IM) from 2013-2021. Four cases of KFD were further characterized using targeted DNA-based next-generation sequencing. Results Systemic symptoms were present in 86% (n = 12/14) of KFD patients, the most common being fever. Laboratory values worrisome for malignancy included cytopenia(s) (n = 9/12), elevated ESR and/or CRP (n = 9/12), elevated ferritin (n = 7/7), and elevated LDH (n = 7/10). Histologically, lymph nodes showed characteristic necrotic foci without neutrophils surrounded by MPO+ “crescentic” histiocytes. Immunoblasts and CD123+ plasmacytoid dendritic cells (pDCs) were also increased surrounding the necrosis. IM lymph nodes showed similar features when necrosis was present but increases in pDCs were patchy and rare neutrophils were seen in the necrotic foci. Molecular analysis of 4 KFD cases did not identify pathogenic variants. Conclusion While the signs/symptoms of KFD are worrisome, there are pathologic features that help differentiate it from potential mimics. We did not identify characteristic molecular features to aid in the work-up of these cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Malignant Mimicker: Features of Kikuchi-Fujimoto Disease in the Pediatric Population

et al. 2022

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“…Cytomegalovirus (CMV), Epstein‐Barr virus (EBV), human herpes virus (HHV‐6, HHV‐7), Parvovirus B19, and mycobacterial species have been identified in lymph node samples from KFD patients, suggesting infectious etiology. 6 Studies have suggested that KFD might be an exuberant T cell–mediated immune response to certain antigenic stimuli in genetically susceptible people. 7 Incidence of KFD is significantly higher in patients with HLADPA1*01 and HLADPB1*0202 allele.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of KFD is unknown; however, infectious and autoimmune correlation have been proposed without conclusive evidence. Cytomegalovirus (CMV), Epstein‐Barr virus (EBV), human herpes virus (HHV‐6, HHV‐7), Parvovirus B19, and mycobacterial species have been identified in lymph node samples from KFD patients, suggesting infectious etiology 6 . Studies have suggested that KFD might be an exuberant T cell–mediated immune response to certain antigenic stimuli in genetically susceptible people 7 .…”

Section: Discussionmentioning

confidence: 99%

Kikuchi‐Fujimoto disease: A rare case report from Nepal

Rauniyar

Acharya

Mishra

et al. 2021

Clinical Case Reports

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“…e exact pathophysiology of KFD is not known, but the two theories postulated are infectious and autoimmune etiology [8]. Xu et al identified CMV,EBV, HHV-6, HHV-7, Parvovirus B19, and mycobacterial species from lymph node samples of 153 patients in China with KFD [9]. KFD has been described in association with SLE, Still's disease, Wegener's granulomatosis, Graves' disease, and Sjogren's disease [3].…”

Section: Discussionmentioning

confidence: 99%

Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis

Sharma

Otieno

Shah

2020

Case Reports in Medicine

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Kikuchi-Fujimoto disease (KFD) is a rare form of painful lymphadenopathy, usually cervical, which is more common in Southeast Asia and rarely reported from Africa. Symptoms are usually nonspecific (fever, night sweats, etc.), and can mimic more common diseases such as tuberculosis (TB) in endemic areas. We report a case of a 29-year-old black African woman who was admitted with headache, neck pain, fever, and lymphadenopathy. She was found to have aseptic meningitis, eventually attributed to TB based on cervical node biopsy, although further histology suggested KFD. Blood tests for systemic lupus erythematosus (SLE) were negative; she had already been commenced on anti-TB treatment and had responded well and so was continued with this therapy. She was also later diagnosed with Hashimoto's thyroiditis 3 months after her diagnosis of KFD. Five months after stopping TB treatment, she was readmitted with the same symptoms and associated painless lymphadenopathy. Repeat biopsy was morphologically similar to that of 2017, and repeat evaluation confirmed SLE. She has since been managed by a rheumatologist and continues to do well.

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Detection of mycobacterial and viral DNA in Kikuchi-Fujimoto disease: an analysis of 153 Chinese pediatric cases

Cited by 5 publications

References 5 publications

A Malignant Mimicker: Features of Kikuchi-Fujimoto Disease in the Pediatric Population

A Malignant Mimicker: Features of Kikuchi-Fujimoto Disease in the Pediatric Population

Kikuchi‐Fujimoto disease: A rare case report from Nepal

Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis

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