A Case of Systemic Lupus Erythematosus Mimicking Kikuchi-Fujimoto Disease

Abstract

Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis is seen usually in patients with cervical lymphadenopathy and high fever. It may frequently occur in young women which has self limited process. KFD has a similar clinical and histopathological diagnosis and it is rarely accompanied with systemic lupus erythematosus (SLE). In this case report, a 36 years old woman who had axillary and cervical lymphadenopathy with fever, lose weight, arthralgia and skin rashes on her face has been admitted to hospital, is presented. Preliminary clinical diagnosis was KFD. Biopsy of enlarged lymph node showed SLE. We present this case because of the difficulties in differential diagnosing with SLE versus KFD. ©2007, Firat University, Medical Faculty

Keywords

• -

Kikuchi – Fujimoto Hastalığı ile Karışan Bir Sistemik Lupus Eritematozus Olgusu

Abstract

Kikuchi- Fujimoto Hastalığı (KFH) ya da histiositik nekrotizan lenfadenit klinik olarak en sık servikal lenfadenit ve yüksek ateş ile seyreden, sıklıkla genç kadınlarda görülen ve kendi kendini sınırlayabilen bir hastalıktır. Klinik ve histolojik açıdan sistemik lupus eritematozus (SLE) ile benzer özellikler gösteren KFH aynı zamanda nadiren SLE ile birlikte seyredebilmektedir. Bu çalışmada koltuk altı ve boyunda şişlik, ateş, kilo kaybı, eklem ağrıları ve yüzünde yara şikayeti ile hastaneye başvuran 36 yaşında bayan hasta KFH öntanısı ile yatırılıp lenf nodu biyopsinin histopatolojik incelemesinde SLE olduğu saptanandı. Olguyu her iki hastalığın ayırıcı tanısının zorluğuna dikkat çekmek amacıyla yayınlamayı uygun bulduk. ©2007, Fırat Üniversitesi, Tıp Fakültesi

Keywords

• Kikuchi- Fujimoto hastalığı, sistemik lupus eritematozus

References

1. Famularo G, Giustiniani MC, Marasco A, etal. Kikuchi Fujimoto lymphadenitis: case report and literature review. Am J Hematol. 2003; 74: 60-63.
2. Sindy Hu, Tseng-tong Kuo, Hong-Shang Hong. Lupus lymphadenitis simulating Kikuchi's lymphadenitis in patients with systemic lupus erythematosus: a clinicopathological analysis of six cases and review of the literature. Pathol Int. 2003; 53: 221-226.
3. Bosch X, Guilabert A, Miquel R, Campo E. Enigmatic Kikuchi- Fujimoto disease: a comprehensive review. Am J Clin Pathol. 2004; 122: 141-152.
4. George TI, Jones CD, Zehnder JL, Warnke RA, Dorfman RF. Lack of human herpesvirus 8 and Epstein-Barr virus in Kikuchi's histiocytic necrotizing lymphadenitis. Hum Pathol 2003; 34: 130- 5.
5. Charalabopoulos K, Charalabopoulos A, Papadapoulou CH, Papalimneu V. Giardia lamblia intestinalis: a new pathogen with possible link to Kikuchi-Fujimoto disease. An additional element in the disease jigsaw. Int J Clin Pract. 2004; 58: 1180-3.
6. Lee KY, Yeon YH, Lee BC. Kikuchi-Fujimoto disease with prolonged fever in children. Pediatrics 2004; 114: 752-6.
7. Papaioannou G, Speletas M, Kaloutsi A, Pavlitou-Tsiontsi A. Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) associated with antiphospholipid syndrome: case report and literature review. Ann Hematol. 2002; 81: 732-735.
8. Eisner MD, Amory J, Mullaney B, Tierney LJ, Browner WS. Necrotizing lymphadenitis associated with systemic lupus erythematosus. Semin Arthritis Rheum 1996; 26: 477-482.

9. Martinez-Vazquez C, Hughes G, Bordon J, et al. F. Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto's disease, associated with systemic lupus erythemotosus. QJM. 1997; 90: 531-3.
10. Aşardağ E, Akalın T, Büyük S, Ağan M, Oruç N, Çağman K, Gulle A. Kikuchi-Fujımoto Hastalığı: Bir Vaka Bildirisi. Klimik Dergisi 2002; 15: 62-66.
11. Wang TJ, Yang YH, Lin YT, Chiang BL. Kikuchi-Fujimoto disease in children: clinical features and disease course. J Microbiol Immunol Infect 2004; 37: 219-224.
12. Katayoun R, Kuchipudi S, Chundi V, et al. Kikuchi-Fujimoto disease: hydroxychloroquine as a treatment. Clin Infect Dis 2004; 39: 124-126.
13. Kabul Tarihi: 18.04.2006