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Axillary involvement in pediatric Kikuchi's disease
D Heldenberg1, M Amar, Y Ben-Arie
1Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel.
Summary
This report details the first Israeli pediatric case of Kikuchi's disease, a rare condition causing fever and swollen lymph nodes in children. Early diagnosis and monitoring are crucial due to potential links with other autoimmune diseases.
Area of Science:
- Pediatrics
- Immunology
- Pathology
Background:
- Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare, benign, and self-limiting condition that primarily affects lymph nodes.
- While KD typically presents with cervical lymphadenopathy and fever, its extranodal and atypical presentations are increasingly recognized.
- This case highlights the importance of considering KD in the differential diagnosis of pediatric fever of unknown origin.
Observation:
- A 10-year-old male presented with migrating arthralgia and fever.
- Physical examination revealed significant axillary adenopathy.
- A lymph node biopsy confirmed histiocytic necrotizing lymphadenitis, consistent with Kikuchi's disease.
Findings:
- This is the first reported pediatric case of Kikuchi's disease in Israel.
- The patient's presentation with migrating arthralgia and fever, alongside axillary adenopathy, led to the diagnosis.
- Histopathological examination of the lymph node biopsy was crucial for confirming the diagnosis.
Implications:
- Kikuchi's disease should be included in the differential diagnosis for children presenting with fever of unknown origin, even without typical cervical lymphadenopathy.
- Long-term follow-up is recommended due to the potential association between Kikuchi's disease and systemic lupus erythematosus (SLE).
- Monitoring for late recurrences and the development of SLE is essential for comprehensive patient management.