title: Kikuchi's lymphadenopathy: a relatively rare but important cause of lymphadenopathy in Greece, potentially associated with the antiphospholipid syndrome.
abstract: Kikuchi-Fujimoto disease is a form of reactive lymphadenopathy, which was firstly described in Japan, but is uncommon in the Western world. We retrospectively reviewed the medical records of nine cases of adult or adolescent Kikuchi's disease diagnosed in a single Haematology Unit in Athens, Greece between 1990 and 2006. The median age of the patients was 25 years (14-40) and 8/9 were females. All patients presented with cervical lymphadenopathy sparing the supraclavicular fossa; one had associated axillary lymphadenopathy, seven had fever and two were asymptomatic. The median duration of lymphadenopathy before presentation was 30 days (10-45). Just palpable splenomegaly was recorded in three patients. The median value of the maximal lymph node diameter was 2 cm (1-5) and only 1/9 had nodes >2 cm in their largest diameter. Lymphadenopathy was tender in two patients; hard nodes were observed in three patients. The median leukocyte count was 4.7 x 10(9)/l (2.2-4.9) with a normal differential in 7/9 patients. No infectious agent could be demonstrated. One patient had clinical and laboratory evidence of primary antiphospholipid syndrome (APLS). In conclusion, Kikuchi's disease represents a rare but important diagnostic possibility for patients presenting with lymphadenopathy in Greece and other western countries. In this setting, autoimmune disorders, mainly lupus and APLS, should be considered and excluded by the appropriate laboratory work-up.
authors.affiliation: First Department of Internal Medicine and Department of Haematology, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Ag. Thoma street, Goudi, Athens, 11527, Greece.
authors.forename: Theodoros P
authors.initials: TP
authors.lastname: Vassilakopoulos
authors.forename: Gerassimos A
authors.initials: GA
authors.lastname: Pangalis
authors.forename: Marina P
authors.initials: MP
authors.lastname: Siakantaris
authors.forename: Georgia
authors.initials: G
authors.lastname: Levidou
authors.forename: Xanthi
authors.initials: X
authors.lastname: Yiakoumis
authors.forename: Charalambos
authors.initials: C
authors.lastname: Floudas
authors.forename: Despina
authors.initials: D
authors.lastname: Gribabis
authors.forename: Spyridon
authors.initials: S
authors.lastname: Bouros
authors.forename: Ioannis
authors.initials: I
authors.lastname: Metaxas
authors.forename: Evangelia M
authors.initials: EM
authors.lastname: Dimitriadou
authors.forename: Lambrini
authors.initials: L
authors.lastname: Pantazi
authors.forename: Catherine
authors.initials: C
authors.lastname: Tsoukala
authors.forename: Penelope
authors.initials: P
authors.lastname: Korkolopoulou
authors.forename: Anastasios
authors.initials: A
authors.lastname: Andreopoulos
authors.forename: George
authors.initials: G
authors.lastname: Vaiopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000032:analysis / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D006115:Greece; D020042:Histiocytic Necrotizing Lymphadenitis / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007958:Leukocyte Count; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D015995:Prevalence; D013154:Spleen / Q000473:pathology / Q000503:physiopathology; D013163:Splenomegaly / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid
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