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[Generalized lymphadenitis associated with Hashimoto's thyroiditis].

A Brecht1, Th Stiegler, J Lange

  • 1Medizinische Klinik III, Nephrologie und Rheumatologie. annebrecht@gmx.de

Deutsche Medizinische Wochenschrift (1946)
|April 20, 2007
PubMed
Summary

Kikuchi disease, a rare cause of lymphadenopathy, was diagnosed in a patient presenting with fever and enlarged lymph nodes. Prompt treatment with prednisone resulted in rapid recovery, highlighting the importance of considering this condition.

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Area of Science:

  • Immunology
  • Pathology
  • Infectious Diseases

Background:

  • Kikuchi-Fujimoto disease is a rare, benign, and self-limiting disorder characterized by necrotizing lymphadenitis.
  • It typically presents with fever and cervical lymphadenopathy, though generalized lymphadenopathy can occur.
  • Diagnosis relies on histopathological examination of lymph node biopsy.

Observation:

  • A 26-year-old woman presented with prolonged fever, nausea, vomiting, abdominal pain, and generalized weakness, accompanied by enlarged cervical lymph nodes.
  • Laboratory investigations revealed pancytopenia, decreased C3/C4 complement levels, positive ANA titer, and serological evidence of past Epstein-Barr virus (EBV), cytomegalovirus (CMV), and other infections.
  • Imaging showed enlarged lymph nodes, spleen, and liver. The patient also had Hashimoto's thyroiditis with latent hypothyroidism.

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Findings:

  • Histopathological analysis of a cervical lymph node biopsy confirmed Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis).
  • Treatment with prednisone (2 mg/kg body weight) led to a rapid and complete resolution of symptoms.
  • The differential diagnosis excluded various infections, including HIV, Bartonella, and dengue fever.

Implications:

  • Kikuchi disease should be considered in the differential diagnosis of cervical and generalized lymphadenopathy, especially after other causes have been ruled out.
  • Lymph node biopsy is crucial for definitive diagnosis.
  • Corticosteroid therapy appears effective for managing Kikuchi disease, leading to favorable outcomes.