Kikuchi Disease and its Association with Systemic Lupus Erythematosus

Abstract

Histiocytic necrotizing lymphadenitis or Kikuchi disease is a rare entity; furthermore, its association with systemic lupus erythematosus (SLE) was only described in 11 patients in seven reports in the world literature. As the disease affects young women and manifests as a systemic illness associated with lymphadenopathy (usually cervical), the importance of continued follow-up to see whether it remains a self-limiting process or evolves into systemic lupus erythematosus should be emphasized.

We present the clinical and histopathological data of eight patients with Kikuchi disease diagnosed in one tertiary care centre, two of whom evolved into SLE. White blood count was normal in all except the two patients who evolved into SLE; erythrocyte sedimentation rate was elevated in all patients tested.

Kikuchi disease could be misdiagnosed as non-Hodgkin's lymphoma or tuberculous lymphadenitis ; furthermore, awareness of its association with SLE is emphasized.

Keywords

Kikuchi Lupus Lymphadenitis

Get full access to this article

View all access options for this article.

References

Kikuchi M.

Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytosis. Nippon Ketsueki

Gakkai Zasshi 1982; 35: 379-80.

Fujimoto Y. , Kozima Y. , Yamaguchi K. Cervical subacute necrotizing lymphadenitis. A new clinicopathological entity . Naika 1972; 20: 920-7.

Dorfman RF , Berry GJ Kikuchi histiocytic necrotizing lymphadenitis: an analysis of 108 cases with emphasis on differential diagnosis. Semin Diagn Pathol 1988 ; 5: 329-45.

Cho KJ , Kim CW , Park SH , Lee SK Necrotizing lymphadenitis: a clinicopathologic study of 36 cases with immunohistochemical analysis. J Korean Med Sci 1991; 6: 55-61.

Hoffmann A. , Kim E. , Kuerten A. et al. Active human herpes virus-6 (HHV-6) infection associated with Kikuchi-Fujimoto disease and systemic lupus erythematosus (SLE). In Vivo 1991; 5: 265-9.

Imamura M. , Vero H. , Matsumura A. et al. An illustrated study of subacute necrotizing lymphadenitis. Am J Pathol 1982; 107: 202-99.

Rivano MT , Falini B. , Stein M. et al. Histiocytic necrotizing lymphadenitis without granulocytic infiltration (Kikuchi lymphadenitis). Morphological and immunohistochemical study of eight cases. Histopathology 1987; 11: 1013-27.

Medeiros LJ , Kaynor B. , Harris NL Lupus lymphadenitis: report of a case with immunohistologic studies on frozen sections. Hum Pathol 1989; 20: 295-9.

Tumiati B. , Bellelli A. , Portioli I. , Prandi S. Kikuchi disease in systemic lupus erythematosus: an independent or dependent event? Clin Rheumatol 1991; 10: 90-3.

10.

Meyer O. , Ribard P. , Belmatoug N. et al. Three cases of Kikuchi lymphadenitis in systemic lupus erythematosus: role of the parvovirus B 19. Ann Med Interne ( Paris) 1991; 142: 259-64.

11.

Litwin MD , Kirkham B. , Henderson DR , Milazzo SC Histiocytic necrotizing lymphadenitis in systemic lupus erythematosus . Ann Rheum Dis 1992; 51: 805-7.

12.

Ohta A. , Matsumoto J. , Ohta T. et al. Still disease associated with necrotizing lymphadenitis (Kikuchi disease): report of 3 cases. J Rheumatol 1988 ; 15: 981-3.

13.

Lyberatos C. Two more cases of Still and Kikuchi. J Rheumatol 1990; 17: 568-9.

14.

Tan EM , Cohen AS , Fries TF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE). Arthritis Rheum 1982; 25: 1271-7.

15.

Dubois EL The clinical picture of systemic lupus erythematosus. In: Lupus Erythematosus, 2nd edn. Dubois EL (ed.). Los Angeles University of Southern California Press, 1974 : 238-343.

16.

Eimoto T. , Kikuchi M. , Mitsui T. Histiocytic necrotizing lymphadenitis. Acta Pathol Jpn 1983; 33: 863-79.