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1/30. Kikuchi's disease with multisystemic involvement and adverse reaction to drugs.

    Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, was initially described in japan in 1972. In the following years, several series of cases involving patients of different ages, races, and geographic origins were reported, but pediatric reports have been rare. The etiology of KD is unknown, although a viral or autoimmune hypothesis has been suggested. The most frequent clinical manifestation consists of local or generalized adenopathy, although in some cases, it is associated with more general symptoms, multiorganic involvement, and diverse analytic changes (leukopenia, elevated erythrocyte sedimentation rate, and c-reactive protein, as well as an increase of transaminases and serum lactic dehydrogenase). diagnosis is based on characteristic pathologic findings that permit differentiation of this disease from lymphoma, systemic lupus erythematosus, and infectious lymphadenopathies. We present here the case of a 14-year-old boy who presented with severe systemic manifestations and transient fulminant hepatic failure in response to treatment with antituberculosis drugs. Kikuchi's disease, lymphadenitis, liver failure, antituberculosis drugs.
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ranking = 1
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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2/30. The histopathology of cutaneous lesions of Kikuchi's disease (necrotizing lymphadenitis): a report of five cases.

    Kikuchi's disease (KD) is an idiopathic, self-limited necrotizing lymphadenitis that can clinically and histologically mimic high-grade lymphoma, including Hodgkin's disease, or can be mistaken for the lymphadenitis of systemic lupus erythematosus (SLE). Involvement of extranodal sites is unusual but well documented, especially in asia, where KD is more common than in north america or europe. The successful distinction of KD from malignant lymphoma and SLE is imperative for the appropriate treatment of affected patients. We describe five patients with cutaneous involvement by KD, all of whom presented with fever, lymphadenopathy, and an eruption on the skin of the upper body, which in one case was clinically suspected to be due to SLE and in another, polymorphous light eruption. The patients ranged in age from 10 months to 42 years (median, 33 years) and included three females and two males. All five patients had negative serologic studies for collagen vascular disease. Each patient had a lymph node biopsy showing the typical necrotizing lymphadenitis of KD. skin biopsies from all five patients shared a specific constellation of histologic features: vacuolar interface change with necrotic keratinocytes, a dense lymphohistiocytic superficial and deep perivascular and interstitial infiltrate, varying amounts of papillary dermal edema, and abundant karyorrhectic debris with a conspicuous absence of neutrophils and a paucity of plasma cells, paralleling the nodal histology in KD. CD68 immunohistochemistry on paraffin-embedded sections showed many histiocytes and plasmacytoid monocytes in all cases, whereas CD3, CD4, and CD8 showed highly variable staining among the cases. There was only rare staining with TIA-1 and CD30. We believe that the papular eruption of KD has recognizable histopathologic features and that a CD68 stain that marks many cells that initially seem to be lymphocytes can be performed to confirm the diagnosis.
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ranking = 1
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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3/30. Kikuchi disease in systemic lupus erythematosus: clinical features and literature review.

    Kikuchi disease (histiocytic necrotizing lymphadenitis) is a rare, benign entity which predominantly affects young women. The disease usually presents with painful or painless enlarged cervical lymph nodes accompanied with fever. The cause of the disease is uncertain and only 17 cases in the literature have been reported in the past to be associated with systemic lupus erythematosus (SLE). We report four cases of SLE with Kikuchi disease in taiwan. This is the first report regarding Kikuchi disease and SLE in taiwan. All patients are female. The mean age is 30 (ranging from 21 to 35 years). The mean history of SLE is 4 years (ranging from 10 days to 8 years). Three of our patients (75%) developed Kikuchi disease accompanied with flare-up of lupus activity, and the other one had Kikuchi disease simultaneously with the onset of SLE. One patient had ribosomal-P antibodies, one had ribonuclear protein (RNP) antibodies and none had antibodies to Ro(SSA) or La (SSB). The cause of association of Kikuchi disease with SLE is still unknown. From our cases, the high frequency of flare-up of lupus disease activity accompanied with the onset of Kikuchi disease and the simultaneous occurrence of these two diseases indicate that they are not independent events. We speculate that Kikuchi disease may be one of the manifestation of SLE.
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ranking = 5.0762579832653
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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4/30. Kikuchi-Fujimoto lymphadenitis with cutaneous involvement.

    We report a case of Kikuchi-Fujimoto disease with cutaneous involvement in a European man. In contrast, the disease is most prevalent in women of Asian descent. The condition is probably under-recognized when histology is not used to identify lymphadenitis of protracted course. skin lesions may mimic clinically other unrelated disorders including lymphomas and immune or infectious dermatoses. histology of skin lesions may bring a clue to the diagnosis when apoptotic plasmacytoid monocytes are recognized. The relationship between Kikuchi-Fujimoto disease and lupus erythematous remains a matter of debate.
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ranking = 0.03812899163264
keywords = lupus
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5/30. Fine needle aspiration cytology in systemic lupus erythematosus lymphadenopathy. A case report.

    BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology characterized by inflammation in various organ systems, including lymph nodes, due to the production of antinuclear antibodies. The onset of disease is between ages 13 and 40 years, with a female preponderance. CASE: A 30-year-old female presented with right cervical lymphadenopathy and gave a history of intermittent fever and swollen joints of 2.5 years' duration. The patient was on intermittent corticosteroids. With a suggestion of tuberculous lymphadenitis, the patient underwent fine needle aspiration (FNA). The diagnosis of lupus adenopathy was established by FNA of enlarged right cervical lymph nodes. Smears showed predominantly typical and atypical immunoblasts, plasma cells, occasional Reed-Sternberg-like cells and dispersed hematoxylin bodies. Smears were negative for acid-fast bacilli. CONCLUSION: When SLE patients develop lymphadenopathy, FNA cytology helps differentiate lupus adenopathy from infectious conditions, such as tuberculous adenitis, and from Kikuchi's lymphadenitis.
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ranking = 4.9084811275651
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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6/30. Kikuchi-Fujimoto necrotizing lymphadenitis associated with cutaneous lupus erythematosus: a case report.

    histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease is a rare entity, and even more rarely, it is associated with other diseases. In a few cases, the condition is associated with cutaneous lupus erythematosus (CLE). histiocytic necrotizing lymphadenitis predominantly affects young women, who present with solitary or multiple cervical lymphadenopathy accompanied by symptoms such as fever, weight loss, sweating, or, in exceptional cases, hepatosplenomegaly. Laboratory examinations show normal or nonspecific results. The disease is of unknown origin, although a viral origin has been suggested, with the suspected agents including Epstein-Barr virus, herpesvirus type 6, and cytomegalovirus (CMV). Although the first and most of the more recent cases have been reported in Oriental patients, the disease has a wide geographic distribution. The clinical evolution is favorable, with spontaneous remission in less than 4 months in almost all cases. We present a case of a 37-year-old woman from peru who presented with cervical adenopathies on two occasions. biopsy of a lymph node revealed a histopathologic picture compatible with Kikuchi-Fujimoto histiocytic necrotizing lymphadenitis. The adenopathy disappeared in a few months. A year later, she presented with a maculopapular rash in the nasal and malar regions. The results of the skin biopsy and immunofluorescence examination were compatible with chronic CLE. The results of the serology testing for CMV were positive. Treatment with chloroquine was initiated, with almost complete recovery by 5 months. No manifestations of systemic lupus erythematosus have occurred since. The epidemiologic, clinical, and anatomopathologic aspects as well as the differential diagnosis of this entity are reviewed.
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ranking = 5.161115721499
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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7/30. Unusual association of Kikuchi's disease and dengue virus infection evolving into systemic lupus erythematosus.

    Kikuchi's disease is a histologically alarming self-limiting condition typically affecting the lymph nodes of young females. A 13-year-old girl was presented with fever, skin rash and cervical lymphadenopathy. On examination she was found febrile, mild pallor was present and she had lymphadenopathy. Liver was palpable. Cervical lymph node biopsy showed histiocytic necrotising lymphadenitis (Kikuchi's disease). dengue virus serology for IgG blot showed evidence of seroconversion in serial samples. She was treated with antibiotics and fluconazole and cyclosporin A. During hospitalisation she developed retinal vasculitis. She was reviewed after one month and showed rashes of subacute cutaneous lupus erythematosus. This case can be described to be a triggering event by dengue viral infection causing abnormal immune response leading initially to Kikuchi's disease and later on to systemic lupus erythematosus.
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ranking = 5.8322231442998
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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8/30. Therapeutic response and long-term follow-up in a systemic lupus erythematosus patient presenting with Kikuchi's disease.

    Kikuchi's disease (KD) can occur in association with systemic lupus erythematosus (SLE). The treatment of concomitant diseases, however, is unclear. We describe a case of a 45-y-old man who presented with generalized histiocytic necrotizing lymphadenitis, fever, malaise and weight loss. Ten months later he also developed arthritis, serositis, anemia, leukopenia and lymphopenia. ANA, anti-Smith, anti-snRNP and anti-Ro antibodies were positive. He responded rapidly and favorably to mid-dose prednisone. hydroxychloroquine, added 5 months later, allowed tapering down and discontinuation of prednisone treatment. He has remained in complete remission for 5 years.
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ranking = 5
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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9/30. Pulmonary haemorrhage in a patient with Kikuchi disease.

    Kikuchi disease is an immunologic disease and most commonly presents with cervical lymphadenopathy. It is usually self-limiting [1]. It is sometimes associated with systemic lupus erythematosus (SLE) [2], and can be associated with many complications including aseptic meningitis, neuropathy, brachial neuritis. It can also be associated with lymphoma, and may sometimes be misdiagnosed as such [3]. The following is the first reported case of Kikuchi disease associated with pulmonary haemorrhage. The patient died and no other cause of the pulmonary haemorrhage could be identified at post mortem.
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ranking = 1
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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10/30. Kikuchi disease with facial rash and erythema multiforme.

    Kikuchi disease, or histiocytic necrotizing lymphadenitis, is a benign illness characterized by fever and cervical lymphadenopathy predominantly in young women. It has a self-limiting course. skin changes occur in about one-third of patients and are of a nonspecific nature. A case of Kikuchi disease with cutaneous involvement in the guise of erythema multiforme and a facial rash is reported. The differential diagnosis with systemic lupus erythematosus and Rowell syndrome is discussed.
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ranking = 1
keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus
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