title: Disseminated intravascular coagulopathy caused by Kikuchi-Fujimoto disease resulting in death: first case report in Turkey.
abstract: Kikuchi disease, also called Kikuchi-Fujimoto disease or Kikuchi's histiocytic necrotizing lymphadenitis, is a rare, benign condition of unknown cause, usually characterized by cervical lymphadenopathy and fever. The diagnosis is based on histopathology. Our patient was a woman with bilateral cervical lymphadenopathy, fever, chest and abdominal pain, fatigue, maculopapular rash on her face, trunk, and upper and lower extremities. Immunological and rheumatological tests were negative. We took a cervical lymph node biopsy that showed a proliferative and necrotizing process centered in the paracortex characterized by patchy circumscribed or confluent areas of necrosis associated with karyorrhexis, and was remarkable by the absence of granulocytes and the paucity of plasma cells. These findings confirmed the diagnosis of Kikuchi's disease. The patient's hemoglobin values decreased, and the peripheral blood smear revealed schistocytes. Blood tests showed raised D-dimer, activated partial thromboplastin time, prothrombin time, and international normalized ratio with decreased fibrinogen. The patient's condition quickly worsened and disseminated intravascular coagulopathy eventually developed. Her initial management consisted of a corticosteroid and hydroxychloroquine.
authors: Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Emine
authors: E
authors: Uslu
authors: Infection Disease Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Sibel
authors: S
authors: Gurbuz
authors: Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Abdulsamet
authors: A
authors: Erden
authors: Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Fatma
authors: F
authors: Aykas
authors: Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Hatice
authors: H
authors: Karagoz
authors: Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Samet
authors: S
authors: Karahan
authors: Clinical Pathology Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Hatice
authors: H
authors: Karaman
authors: Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Ali
authors: A
authors: Cetinkaya
authors: Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey.
authors: Deniz
authors: D
authors: Avci
keywords: Kikuchi–Fujimoto disease; disseminated intravascular coagulopathy; necrotizing lymphadenitis