Kikuchi-Fujimoto disease associated with systemic lupus erythematosus

Area of Science:

• Rheumatology
• Pathology
• Nephrology

Background:

• Necrotizing lymphadenitis, diagnosed as Kikuchi-Fujimoto Disease (KFD), can present challenges in differential diagnosis.
• Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical manifestations.

Observation:

• A 38-year-old woman presented with cervical lymphadenopathy initially diagnosed as KFD.
• Initial investigations, including renal biopsy, did not reveal evidence of SLE.
• The patient was treated with prednisone for presumed KFD.

Findings:

• One year later, the patient developed renal failure, and a repeat renal biopsy confirmed Class IV SLE.
• This case demonstrates a diagnostic evolution from KFD to SLE in the same patient.

Implications:

• The findings suggest that KFD may represent an early or incomplete manifestation of SLE in some cases.
• Healthcare providers should maintain a high index of suspicion for evolving SLE in patients initially diagnosed with KFD.
• Timely recognition and management of evolving SLE are crucial for preventing long-term organ damage.