Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin
Background: Kikuchi-Fujimoto disease, a benign self-limited lymphadenopathy is an uncommon cause of pyrexia of unknown origin (PUO). Methods: We retrospectively studied the case-records of 13 patients presenting with PUO who were diagnosed to have Kikuchi-Fujimoto disease on peripheral lymph node...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Journal of Clinical and Scientific Research |
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| Online Access: | http://svimstpt.ap.nic.in/jcsr/jan-mar14_files/oa114.pdf |
| _version_ | 1818490669345275904 |
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| author | Alladi Mohan J. Harikrishna D. Prabath Kumar N. Dinesh Kumar K. Radhika B.V. Phaneendra |
| author_facet | Alladi Mohan J. Harikrishna D. Prabath Kumar N. Dinesh Kumar K. Radhika B.V. Phaneendra |
| author_sort | Alladi Mohan |
| collection | DOAJ |
| description | Background: Kikuchi-Fujimoto disease, a benign self-limited lymphadenopathy is an uncommon cause of pyrexia of
unknown origin (PUO).
Methods: We retrospectively studied the case-records of 13 patients presenting with PUO who were diagnosed to have Kikuchi-Fujimoto disease on peripheral lymph node excision biopsy and report the salient clinical manifestations and histopathological findings in them. All of them received symptomatic treatment.
Results: Their median age was 28 [interquartile range (IQR) 18.5-38.0] years. Women (11/13, 84.6%) were more frequently affected. All of them were human immunodeficiency virus (HIV) seronegative. Prior to presenting to us, two were being treated for lymph node tuberculosis with DOTS. Cervical lymph nodes were predominantly involved, the distribution being: right cervical (n=10, 76.9%); left cervical (n=4); and bilateral cervical (n=2). Axillary and generalized lymphadenopathy were rare being seen in 2 and 1 patient respectively. The median (IQR) erythrocyte sedimentation rate (n=11) was 53 (35-89) mm at the end of first hour. Salient histopathological features were paracortical patchy zones of eosinophilic fibrinoid necrosis with karyorrhectic debris, large numbers of histiocytes, including histiocytes with peripherally placed “crescentic” nuclei. Spontaneous regression of fever and lymphadenopathy was observed over a median (IQR) period of 8 (6.75-10.25) months in all of them.
Conclusions: Kikuchi-Fujimoto disease is a rare but important cause of PUO presenting with peripheral lymphadenopathy. Women are most often affected and cervical lymph nodes are the most frequently involved site. Clinical suspicion and thoughtful collaboration between clinicians and pathologists are essential for accurate diagnosis, and to minimize unnecessary investigations and inappropriate aggressive treatment. |
| first_indexed | 2024-12-10T17:20:00Z |
| format | Article |
| id | doaj.art-054b3142635b498b9f5a07d8e5cfc79a |
| institution | Directory Open Access Journal |
| issn | 2277-5706 2277-8357 |
| language | English |
| last_indexed | 2024-12-10T17:20:00Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Clinical and Scientific Research |
| spelling | doaj.art-054b3142635b498b9f5a07d8e5cfc79a2022-12-22T01:40:00ZengWolters Kluwer Medknow PublicationsJournal of Clinical and Scientific Research2277-57062277-83572014-01-013126Kikuchi-Fujimoto disease presenting as pyrexia of unknown originAlladi Mohan0J. Harikrishna1D. Prabath Kumar2 N. Dinesh Kumar3 K. Radhika4B.V. Phaneendra5Departments of Medicine, Sri Venkateswara Institute of Medical Sciences, TirupatiDepartments of Medicine, Sri Venkateswara Institute of Medical Sciences, TirupatiDepartments of Medicine, Sri Venkateswara Institute of Medical Sciences, TirupatiDepartments of Medicine, Sri Venkateswara Institute of Medical Sciences, TirupatiDepartment of Pathology, Sri Venkateswara Institute of Medical Sciences, TirupatiDepartment of Pathology, Sri Venkateswara Institute of Medical Sciences, TirupatiBackground: Kikuchi-Fujimoto disease, a benign self-limited lymphadenopathy is an uncommon cause of pyrexia of unknown origin (PUO). Methods: We retrospectively studied the case-records of 13 patients presenting with PUO who were diagnosed to have Kikuchi-Fujimoto disease on peripheral lymph node excision biopsy and report the salient clinical manifestations and histopathological findings in them. All of them received symptomatic treatment. Results: Their median age was 28 [interquartile range (IQR) 18.5-38.0] years. Women (11/13, 84.6%) were more frequently affected. All of them were human immunodeficiency virus (HIV) seronegative. Prior to presenting to us, two were being treated for lymph node tuberculosis with DOTS. Cervical lymph nodes were predominantly involved, the distribution being: right cervical (n=10, 76.9%); left cervical (n=4); and bilateral cervical (n=2). Axillary and generalized lymphadenopathy were rare being seen in 2 and 1 patient respectively. The median (IQR) erythrocyte sedimentation rate (n=11) was 53 (35-89) mm at the end of first hour. Salient histopathological features were paracortical patchy zones of eosinophilic fibrinoid necrosis with karyorrhectic debris, large numbers of histiocytes, including histiocytes with peripherally placed “crescentic” nuclei. Spontaneous regression of fever and lymphadenopathy was observed over a median (IQR) period of 8 (6.75-10.25) months in all of them. Conclusions: Kikuchi-Fujimoto disease is a rare but important cause of PUO presenting with peripheral lymphadenopathy. Women are most often affected and cervical lymph nodes are the most frequently involved site. Clinical suspicion and thoughtful collaboration between clinicians and pathologists are essential for accurate diagnosis, and to minimize unnecessary investigations and inappropriate aggressive treatment.http://svimstpt.ap.nic.in/jcsr/jan-mar14_files/oa114.pdfKikuchi-Fujimoto diseaseIndia |
| spellingShingle | Alladi Mohan J. Harikrishna D. Prabath Kumar N. Dinesh Kumar K. Radhika B.V. Phaneendra Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin Journal of Clinical and Scientific Research Kikuchi-Fujimoto disease India |
| title | Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin |
| title_full | Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin |
| title_fullStr | Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin |
| title_full_unstemmed | Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin |
| title_short | Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin |
| title_sort | kikuchi fujimoto disease presenting as pyrexia of unknown origin |
| topic | Kikuchi-Fujimoto disease India |
| url | http://svimstpt.ap.nic.in/jcsr/jan-mar14_files/oa114.pdf |
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