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Relapsing Kikuchi-Fujimoto Disease Requiring Prolonged Steroid Therapy
Ulrich Gerwig1, Rolf Guenter Weidmann1, Gregor Lindner1
1Department of General Internal Medicine & Emergency Medicine, Hirslanden, Klinik Im Park, Seestrasse 220, 8027 Zurich, Switzerland.
Abstract:
We report the case of a 26-year-old woman with an eight-week history of painfully enlarged cervical lymph nodes, recurrent headache, and malaise. Her medical history was unremarkable. The physical examination showed multiple enlarged cervical lymph nodes. Laboratory examination was unremarkable, and magnetic resonance tomographic imaging showed multiple enlarged cervical lymph nodes with aspect of a lymphoma. Lymph node biopsy revealed Kikuchi-Fujimoto disease, histologically characterized by histiocytic necrotizing lymphadenitis. A therapeutic trial with nonsteroidal anti-inflammatory drugs (NSAID) showed no effect, so steroid therapy was started. Due to relapse of symptoms after steroid withdrawal the tapering regimen was prolonged for a total of seven months.
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