Kikuchi-Fujimoto Disease in a Crohn's Patient

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, focal, self-limiting disease. We report a unique case of KFD in a patient with coexisting Crohn's disease. Our patient is a 23-year-old African American female with a past medical history significant for Crohn's disease who presented to the clinic because of a painless lump over the right side of the neck for the past 3 weeks. On physical examination, the patient was found to have enlarged nontender right cervical lymph nodes from levels 2 to 4. An excisional biopsy of the right neck lymph node was done which revealed necrotizing histiocytic lymphadenitis, favoring a diagnosis of KFD. Over the course of the next 2 months, her lymphadenopathy got resolved. This is the first case of KFD in a patient with Crohn's Disease. Lymphoma remains a feared adverse outcome for immunomodulatory drugs, thus necessitating their cessation upon signs of lymphadenopathy. Our case highlights the importance of a detailed workup in order to access the underlying cause of the lymphadenopathy so that the immunomodulatory drugs can be resumed in these patients.