title: [Kikuchi-Fujimoto disease].
abstract: Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a rare, benign, self-limited condition of unknown etiology. A 16-year-old woman with no relevant clinical history seeks medical attention for fever and cervical adenopathies. In a physical examination the patient is found to be febrile (38.5 C) with multiple bilateral, hard-elastic cervical adenopathies, congestive oropharynx and mild splenomegaly with no other relevant pathological findings. The laboratory examination shows signs of pancytopenia and an increase in the erythrocyte sedimentation rate, Β2-microglobulin, transaminases and lactate dehydrogenase. Several serological tests are carried out with negative results except for immunoglobulin G for parvovirus, which is positive. A computerized axial tomography scan of head, neck, thorax, abdomen and pelvis shows bilateral lateral cervical adenomegalies (the largest with a size of 15 mm) and bilateral axillary adenomega- lies of less than 10 mm in diameter; small basal lung condensations with mild pleural effusion, mild homogeneous splenomegaly, and a small amount of free fluid in the abdominal cavity at the bottom of the Douglas cul-de-sac. Possible respiratory and gynecological infections are treated with ampicillin/sulbactam together with doxycycline. The patient progresses with persistence of the symptoms. A lymph node biopsy is then performed, revealing a morphology compatible with Kikuchi-Fujimoto disease. Treatment with prednisone is initiated with a clinical and laboratory improvement in the patient's condition. Kikuchi-Fujimoto disease is probably under-reported and under-diagnosed due to the low index of suspicion. Greater awareness of this illness would result in clinicians arriving at this diagnosis more often.
authors.affiliation: Concurrencia de Clínica Médica, Sanatorio Americano, Rosario, Santa Fe. mariquenacorral@hotmail.com
authors.forename: Mariquena
authors.initials: M
authors.lastname: Corral
authors.forename: Inés
authors.initials: I
authors.lastname: Huergo
authors.forename: Marina
authors.initials: M
authors.lastname: Alianak
authors.forename: Florencia
authors.initials: F
authors.lastname: Staffieri
authors.forename: Ana
authors.initials: A
authors.lastname: Fainberg
authors.forename: Fernando
authors.initials: F
authors.lastname: Staffieri
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001706:Biopsy; D005260:Female; D020042:Histiocytic Necrotizing Lymphadenitis / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008198:Lymph Nodes / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D007074:Immunoglobulin G; D011241:Prednisone