Optic neuritis revealing Kikuchi-Fujimoto disease.

Area of Science:

• Neurology
• Ophthalmology
• Rheumatology
• Pathology

Background:

• Kikuchi-Fujimoto disease (KFD) is a rare, benign, systemic histiocytic necrotizing lymphadenitis.
• Neurological involvement in KFD is uncommon, with ocular manifestations being particularly rare.
• Optic neuritis, inflammation of the optic nerve, can lead to significant vision impairment.

Observation:

• A 30-year-old Asian woman presented with rapidly progressive vision loss.
• Ophthalmic examination revealed inflammation of the left optic nerve with chiasmatic involvement.
• Imaging confirmed optic nerve inflammation without brain or spinal cord lesions.

Findings:

• Thoracic CT scan identified bilateral axillary lymphadenopathy.
• Axillary lymph node biopsy revealed characteristic histological findings of Kikuchi-Fujimoto disease.
• No evidence of associated systemic lupus erythematosus was found.

Implications:

• This case represents the first documented instance of optic neuritis associated with Kikuchi-Fujimoto disease.
• The patient experienced spontaneous recovery of visual acuity and resolution of MRI abnormalities within 4 weeks.
• The findings suggest that KFD should be considered in the differential diagnosis of optic neuritis, even in the absence of typical systemic symptoms.