Medical Study of 69 Cases Diagnosed as Kikuchiʼs Disease

Nakamura, Itaru; Imamura, Akifumi; Yanagisawa, Naoki; Suganuma, Akihiko; Ajisawa, Atsushi

doi:10.11150/kansenshogakuzasshi.83.363

Cited by 17 publications

(25 citation statements)

References 15 publications

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“…There is much speculation as to the etiology of KFD. One possibility is that it is a lupus-like autoimmune condition triggered by certain infections, and in some cases the histologic findings associated with KFD are difficult to distinguish from those of SLE-associated lymphadenitis (3)(4)(5)(6)(11)(12)(13). However, there was no evidence of any autoimmune disorders or active infection (including tuberculosis) in the present case.…”

Section: Discussionmentioning

confidence: 46%

“…Also known as subacute necrotizing lymphadenitis, KFD often presents as a painful cervical lymphadenopathy in young women (3,4,6). It was first described in 1972 by both Kikuchi (1), and Fujimoto and colleagues (2).…”

Section: Discussionmentioning

confidence: 99%

“…The most common clinical symptom is cervical lymphadenopathy, with or without fever. Laboratory findings are nonspecific (4,11). There is much speculation as to the etiology of KFD.…”

Section: Discussionmentioning

confidence: 99%

“…The presenting symptoms of fever and cervical lymphadenopathy mimic those of tuberculous lymphadenitis (5,6), and care should be taken to distinguish between the two; comprehensive history-taking and physical examination are important for establishing a correct diagnosis of lymphadenopathy (7). Although definitive diagnosis requires surgical biopsy, patients may be hesitant to consent to the procedure because of cosmetic concerns (4). For this reason, noninvasive approaches ( including blood examination, interferon-gamma release assay [QuantiFERON -TB Gold In-Tube; QFT], fluorodeoxyglucose positron emission tomography (FDG-PET), and gallium scintigraphy) are helpful in differentiating KFD from similarly presenting diseases like malignant lymphoma, metastasis, tuberculous lymphadenitis and sarcoidosis (7).…”

Section: Introductionmentioning

confidence: 99%

“…Histiocytic necrotizing lymphadenitis, or KikuchiFujimoto disease (KFD), was first described in 1972 (1,2); it is a benign disease mainly affecting young women (3)(4)(5)(6). The presenting symptoms of fever and cervical lymphadenopathy mimic those of tuberculous lymphadenitis (5,6), and care should be taken to distinguish between the two; comprehensive history-taking and physical examination are important for establishing a correct diagnosis of lymphadenopathy (7).…”

Section: Introductionmentioning

confidence: 99%

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Kikuchi-Fujimoto Disease Mimicking Tuberculous Lymphadenitis

et al. 2012

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A 28-year-old woman was referred to our hospital for treatment of tuberculous lymphadenitis, after presenting with fever, left cervical lymphadenopathy, and a positive interferon-gamma release assay (Quanti-FERON -TB Gold In-Tube; QFT) result. Surprisingly, biopsy specimens of the cervical lymph nodes showed necrotic lesions with prominent nuclear debris and a proliferation of histiocytes, consistent with KikuchiFujimoto disease (KFD). A diagnosis was made of KFD complicated by latent tuberculosis infection (LTBI), and all symptoms had resolved completely two months post-diagnosis. KFD may be misdiagnosed as tuberculous lymphadenitis, and antibiotics unnecessarily prescribed. Careful attention should therefore be paid when diagnosing cervical lymphadenopathy.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

“…The most common clinical symptom is cervical lymphadenopathy, with or without fever. Laboratory findings are nonspecific (4,11). There is much speculation as to the etiology of KFD.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Kikuchi-Fujimoto Disease Mimicking Tuberculous Lymphadenitis

et al. 2012

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Kikuchi‐fujimoto disease in fine‐needle aspiration smears: A clinico‐cytologic study of 76 cases of KFD and 684 cases of reactive hyperplasia of the lymph node

Das

Mallik

Dashti

et al. 2011

Diagnostic Cytopathology

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Kikuchi-Fujimoto disease (KFD) is cytologically characterized by a polymorphous lymphoid cell population, abundant karyorrhectic debris and histiocytes, many of which are crescentic (Kikuchi histiocytes). As per reviewed literature, KFD may be confused with tuberculosis, lymphoma, and reactive hyperplasia of lymph nodes (RHLN). Since RHLN was found to be a major challenging factor during routine cytodiagnosis of KFD in our material, we tried to find out the differentiating clinico-cytologic features between 76 KFD and 684 RHLN cases seen in Kuwait. 63.2% of KFD were in 3rd and 4th decades of life as compared to 40.2% of RHLN (P = 0.0002). Male to female ratio was 1: 2.45 for KFD and 1:1.09 for RHLN (P = 0.0022). Kuwaiti:non-Kuwaiti ratio was 1:2.04 for KFD and 1.31:1 for RHLN (P < 0.0001). Capillary networks was present in 71.1% of KFD smears and 52.6% of RHLN (P = 0.0023). Tingible body macrophages and dendritic reticulum cells were detected in 17.1% and 22.4%, respectively, in KFD as opposed to 50.1% and 58.8%, respectively, in RHLN (P < 0.0001). Kikuchi histiocyte count ranged from 2 to 36% in KFD and was ≥10% in 31 (40.8%). Rare Kikuchi histiocytes were detected in 16 (2.3%) of RHLN cases but in none of them the count exceeded 1%, whereas their count was >1% in all KFD cases (P < 0.0001). Thus, KFD cases differed significantly from RHLN in respect of age and sex distribution, Kuwaiti:non-Kuwaiti ratio, and cytomorphologic features such as capillary networks, Kikuchi histiocyte count, dendritic reticulum cells, and tingible body macrophages.

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Co-occurrence of Kikuchi-Fujimoto’s disease and Still’s disease: case report and review of previously reported cases

Toribio

Kamino

et al. 2014

Clin Rheumatol

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Kikuchi-Fujimoto's disease (KFD) and adult-onset Still's disease (AOSD) are rare inflammatory conditions with some overlapping features. We encountered a 22-year-old male patient who presented with daily fevers, neck discomfort, and sore throat and subsequently developed rash, arthritis, and cervical lymphadenopathy. Biopsy of the skin rash was consistent with KFD skin involvement. Given that the patient also met criteria for AOSD, a final diagnosis of KFD/AOSD co-occurrence was made. Anti-IL-1β therapy with anakinra resulted in rapid resolution of all symptoms. A literature search identified eight more cases of KFD/AOSD. Fever, rash, arthritis, and lymphadenopathy were present in all patients. No case report demonstrated an association of rash eruption clearly associated with fever spikes. Duration of symptoms ranged from 3 weeks to 10 years. Seven patients had leukocytosis, six had anemia, and five demonstrated elevated ferritin and/or decreased glycosylated ferritin. Seven patients had elevated erythrocyte sedimentation rate (ESR), and seven had transaminitis. Eight of nine patients had no evidence of infectious disease. Autoantibodies were absent from all patients. KFD and AOSD are very rare diseases, yet they may overlap. The two conditions not only share several clinical and laboratory characteristics but also differ in characteristic ways. Given the rapid response observed with anakinra in the index patient, IL-1β likely plays a role in both diseases.

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Medical Study of 69 Cases Diagnosed as Kikuchiʼs Disease

Cited by 17 publications

References 15 publications

Kikuchi-Fujimoto Disease Mimicking Tuberculous Lymphadenitis

Kikuchi-Fujimoto Disease Mimicking Tuberculous Lymphadenitis

Kikuchi‐fujimoto disease in fine‐needle aspiration smears: A clinico‐cytologic study of 76 cases of KFD and 684 cases of reactive hyperplasia of the lymph node

Co-occurrence of Kikuchi-Fujimoto’s disease and Still’s disease: case report and review of previously reported cases

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