A Case Report of Kikuchi Fujimoto Disease as an Antecedent Illness of Systemic Lupus Erythematosus in a Male

Abstract

Kikuchi Fujimoto disease (KFD) is a rare benign self-limiting condition described in young females characterized by lymphadenopathy and fever. It has been associated with several infective and autoimmune diseases, among which systemic lupus erythematosus (SLE) is relatively common. Kikuchi disease could occur either as a proceeding illness or as a coexisting illness with SLE. The presence of necrotizing lymphadenitis is appreciated in the histological specimen to confirm the diagnosis. Anti-nuclear antibody (ANA) positivity implicates a possible correlation with SLE or recurrence of the pre-existing disease. This clinical presentation needs to be evaluated thoroughly to prevent misdiagnosis and inappropriate treatment. Although Kikuchi disease generally warrants supportive treatment, steroids and immune therapy play a role in treating this persistent and recurrent disease. Long-term surveillance is mandatory for the early detection of sinister pathologies.

Keywords: antinuclear antibody; cervical lymphadenopathy; kikuchi fujimoto disease; male; systemic lupus erythematosus.

Figure 1. Palatal petechiae with ulcers in the oral mucosa

Figure 2. Malar rash in systemic lupus erythematosus sparing the nasolabial folds

Figure 3. Hematoxylin and eosin stained lymph node showing distorted architecture by confluent areas of necrosis (red arrow)

Figure 4. Pancortex expansion of the lymph node showing increased histiocytes containing karyorrhectic nuclear debris (red arrow) and plasmacytoid dendritic cells