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A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease

Yıl 2024, Cilt: 24 Sayı: 4, 248 - 251, 24.02.2025
https://doi.org/10.26650/jchild.2024.1572282

Öz

Kikuchi Fujimato Disease (KFD) is a rare and benign cause of cervical lymphadenopathy associated with fever. It is important to be aware of this disease as it is included in the differential diagnosis of diseases with high morbidity and mortality, such as lymphoma and tuberculosis. This study presents a child diagnosed with KFD to raise awareness of the disease. A 15-year-old female patient was admitted with neck swelling, weight loss, and fever for three weeks without response to antibiotic treatment. On examination, her temperature was 38oC, she had 3-4 fixed, painful, and hard cervical lymph nodes in cervical chains, the spleen was palpable at 1.5 cm, the liver at 1 cm, and other systems examination was normal. Laboratory tests revealed a neutrophil count of 770/L, lymphocyte of 800/L, C-reactive protein of 16.99 mg/L, and erythrocyte sedimentation rate (ESR) of 120 mm/h. Her fever and fatigue persisted during hospitalization, and no tests reveals infectious diseases. Peripheral blood smears, bone marrow aspiration microscopy, and flow cytometry did not reveal any findings in favor of malignancy, and excisional lymph node biopsy was performed for diagnosis. Histopathological examination was consistent with Kikuchi Fujimoto Disease. Antinuclear antibody (ANA) positivity (+++). The patient’s fever and partial lymphadenopathy resolved after 14 days of hospitalization, and the ESR decreased to 40 mm/h at 4 months. Systemic lupus erythematous (SLE) and hemophagocytosis can complicated KFD, so the follow-up patient continues. It is difficult to distinguish KFD from serious diseases clinically and in the laboratory. Differential diagnosis through histopathological evaluation is associated with the awareness of the clinician and the experience of the pathologist. With an early diagnosis, unnecessary examinations and treatments can be prevented.

Kaynakça

  • Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes: a clinicopathological study. Acta Hematol Jpn. 1972;35:379-380. google scholar
  • Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis: a new clinicopathologic entity. Naika. 1972;20:920-927. google scholar
  • Iguchi H, Sunami K, Yamane H, Konishi K, Takayama M, Nakai Y, et al. Apoptotic cell death in Kikuchi’s disease: a TEM study. Acta Otolaryngol Suppl. 1998;538:250. google scholar
  • Ura H, Yamada N, Torii H, Imakado S, Iozumi K, Shimada S. Histiocytic necrotizing lymphadenitis (Kikuchi’s disease): the necrotic appearance of the lymph node cells is caused by apoptosis. . J Dermatol. 1999;26(6):385. google scholar
  • Lin HC, Su CY, Huang CC, Hwang CF, Chien CY . Kikuchi’s disease: a review and analysis of 61 cases. Otolaryngol Head Neck Surg. 2003;128(5):650. google scholar
  • Dumas G, Prendki V, Haroche J, Amoura Z, Cacoub P, Galicier L, et al. Kikuchi-Fujimoto disease: retrospective study of 91 cases and review of the literature. Medicine (Baltimore). 2014;93(24):372. google scholar
  • Ahn SS, Lee B, Kim D, Jung SM, Lee S-W, Park M-C, et al. Evaluation of macrophage activation syndrome in hospitalised patients with Kikuchi-Fujimoto disease based on the 2016 EULAR/ACR/PRINTO classification criteria. PLoS One 2019; 14(e0219970). google scholar
  • Lin HC, Su CY, Huang CC, Hwang C-F, Chein C-Y. Kikuchi’s disease: a review and analysis of 61 cases. Otolaryngol Head Neck Surg 2003; 128(650). google scholar
  • Hudnall SD, Chen T, Amr S, Young KH, Hery K. Detection of human herpesvirus DNA in Kikuchi-Fujimoto disease and reactive lymphoid hyperplasia. Int J Clin Exp Pathol 2008; 1(362). google scholar
  • Chiu CF, Chow KC, Lin TY, Tsai MH, Shih CM, Chen LM. Virus infection in patients with histiocytic necrotizing lymphadenitis in Taiwan. Detection of Epstein-Barr virus, type I human T-cell lymphotropic virus, and parvovirus B19. Am J Clin Pathol 2000; 113(774). google scholar
  • Kucukardali Y, Solmazgul E, Kunter E, Oncul O, Yıldırım S, Kaplan M. Kikuchi-Fujimoto Disease: analysis of 244 cases. Clin Rheumatol 2007; 26(50). google scholar
  • Song JY, Cheong HJ, Kee SY, Lee J, Sohn JW, Kim MJ. Disease spectrum of cervical lymphadenitis: analysis based on ultrasound-guided core-needle gun biopsy. J Infect 2007; 55(310). google scholar
  • Ryoo I, Suh S, Lee YH, Seo HS, Seol HY. Comparison of ultrasonographic findings of biopsy-proven tuberculous lymphadenitis and Kikuchi disease. Korean J Radiol 2015; 16(767). google scholar
  • Lin DY, Villegas MS, Tan PL, Wang S, Shek LP. Severe Kikuchi’s disease responsive to immune modulation. Singapore Med J 2010; 51(e18). google scholar
  • Rezai K, Kuchipudi S, Chundi V, Ariga R, Loew J, Sha BE, et al. Kikuchi-Fujimoto disease: hydroxychloroquine as a treatment. Clin Infect Dis 2004; 39(e124). google scholar
  • Hyun M, So IT, Kim HA, Jung H, Ryu SY. Recurrent Kikuchi’s disease treated by hydroxychloroquine. Infect Chemother 2016; 48(127). google scholar
  • Faheem B, Kumar V, Ashkar H, Ket al. Recurrent Kikuchi-Fujimoto disease masquerading as lymphoma successfully treated by anakinra cureus 2020; 12(e11655). google scholar
Yıl 2024, Cilt: 24 Sayı: 4, 248 - 251, 24.02.2025
https://doi.org/10.26650/jchild.2024.1572282

Öz

Kaynakça

  • Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes: a clinicopathological study. Acta Hematol Jpn. 1972;35:379-380. google scholar
  • Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis: a new clinicopathologic entity. Naika. 1972;20:920-927. google scholar
  • Iguchi H, Sunami K, Yamane H, Konishi K, Takayama M, Nakai Y, et al. Apoptotic cell death in Kikuchi’s disease: a TEM study. Acta Otolaryngol Suppl. 1998;538:250. google scholar
  • Ura H, Yamada N, Torii H, Imakado S, Iozumi K, Shimada S. Histiocytic necrotizing lymphadenitis (Kikuchi’s disease): the necrotic appearance of the lymph node cells is caused by apoptosis. . J Dermatol. 1999;26(6):385. google scholar
  • Lin HC, Su CY, Huang CC, Hwang CF, Chien CY . Kikuchi’s disease: a review and analysis of 61 cases. Otolaryngol Head Neck Surg. 2003;128(5):650. google scholar
  • Dumas G, Prendki V, Haroche J, Amoura Z, Cacoub P, Galicier L, et al. Kikuchi-Fujimoto disease: retrospective study of 91 cases and review of the literature. Medicine (Baltimore). 2014;93(24):372. google scholar
  • Ahn SS, Lee B, Kim D, Jung SM, Lee S-W, Park M-C, et al. Evaluation of macrophage activation syndrome in hospitalised patients with Kikuchi-Fujimoto disease based on the 2016 EULAR/ACR/PRINTO classification criteria. PLoS One 2019; 14(e0219970). google scholar
  • Lin HC, Su CY, Huang CC, Hwang C-F, Chein C-Y. Kikuchi’s disease: a review and analysis of 61 cases. Otolaryngol Head Neck Surg 2003; 128(650). google scholar
  • Hudnall SD, Chen T, Amr S, Young KH, Hery K. Detection of human herpesvirus DNA in Kikuchi-Fujimoto disease and reactive lymphoid hyperplasia. Int J Clin Exp Pathol 2008; 1(362). google scholar
  • Chiu CF, Chow KC, Lin TY, Tsai MH, Shih CM, Chen LM. Virus infection in patients with histiocytic necrotizing lymphadenitis in Taiwan. Detection of Epstein-Barr virus, type I human T-cell lymphotropic virus, and parvovirus B19. Am J Clin Pathol 2000; 113(774). google scholar
  • Kucukardali Y, Solmazgul E, Kunter E, Oncul O, Yıldırım S, Kaplan M. Kikuchi-Fujimoto Disease: analysis of 244 cases. Clin Rheumatol 2007; 26(50). google scholar
  • Song JY, Cheong HJ, Kee SY, Lee J, Sohn JW, Kim MJ. Disease spectrum of cervical lymphadenitis: analysis based on ultrasound-guided core-needle gun biopsy. J Infect 2007; 55(310). google scholar
  • Ryoo I, Suh S, Lee YH, Seo HS, Seol HY. Comparison of ultrasonographic findings of biopsy-proven tuberculous lymphadenitis and Kikuchi disease. Korean J Radiol 2015; 16(767). google scholar
  • Lin DY, Villegas MS, Tan PL, Wang S, Shek LP. Severe Kikuchi’s disease responsive to immune modulation. Singapore Med J 2010; 51(e18). google scholar
  • Rezai K, Kuchipudi S, Chundi V, Ariga R, Loew J, Sha BE, et al. Kikuchi-Fujimoto disease: hydroxychloroquine as a treatment. Clin Infect Dis 2004; 39(e124). google scholar
  • Hyun M, So IT, Kim HA, Jung H, Ryu SY. Recurrent Kikuchi’s disease treated by hydroxychloroquine. Infect Chemother 2016; 48(127). google scholar
  • Faheem B, Kumar V, Ashkar H, Ket al. Recurrent Kikuchi-Fujimoto disease masquerading as lymphoma successfully treated by anakinra cureus 2020; 12(e11655). google scholar
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Bulaşıcı Hastalıkları
Bölüm Olgu Sunumu
Yazarlar

Mustafa Safa Tural 0000-0002-1539-9355

Sevliya Öcal Demir 0000-0002-7175-303X

Aylin Canbolat 0000-0001-6173-2350

Bengü Çobanoğlu Şimşek 0000-0003-2639-2017

Yayımlanma Tarihi 24 Şubat 2025
Gönderilme Tarihi 23 Ekim 2024
Kabul Tarihi 2 Aralık 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 24 Sayı: 4

Kaynak Göster

APA Tural, M. S., Öcal Demir, S., Canbolat, A., Çobanoğlu Şimşek, B. (2025). A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease. Çocuk Dergisi, 24(4), 248-251. https://doi.org/10.26650/jchild.2024.1572282
AMA Tural MS, Öcal Demir S, Canbolat A, Çobanoğlu Şimşek B. A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease. Çocuk Dergisi. Şubat 2025;24(4):248-251. doi:10.26650/jchild.2024.1572282
Chicago Tural, Mustafa Safa, Sevliya Öcal Demir, Aylin Canbolat, ve Bengü Çobanoğlu Şimşek. “A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease”. Çocuk Dergisi 24, sy. 4 (Şubat 2025): 248-51. https://doi.org/10.26650/jchild.2024.1572282.
EndNote Tural MS, Öcal Demir S, Canbolat A, Çobanoğlu Şimşek B (01 Şubat 2025) A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease. Çocuk Dergisi 24 4 248–251.
IEEE M. S. Tural, S. Öcal Demir, A. Canbolat, ve B. Çobanoğlu Şimşek, “A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease”, Çocuk Dergisi, c. 24, sy. 4, ss. 248–251, 2025, doi: 10.26650/jchild.2024.1572282.
ISNAD Tural, Mustafa Safa vd. “A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease”. Çocuk Dergisi 24/4 (Şubat 2025), 248-251. https://doi.org/10.26650/jchild.2024.1572282.
JAMA Tural MS, Öcal Demir S, Canbolat A, Çobanoğlu Şimşek B. A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease. Çocuk Dergisi. 2025;24:248–251.
MLA Tural, Mustafa Safa vd. “A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease”. Çocuk Dergisi, c. 24, sy. 4, 2025, ss. 248-51, doi:10.26650/jchild.2024.1572282.
Vancouver Tural MS, Öcal Demir S, Canbolat A, Çobanoğlu Şimşek B. A Rare Cause of Prolonged Fever and Cervical Lymphadenopathy: Kikuchi Fujimoto Disease. Çocuk Dergisi. 2025;24(4):248-51.