Sharma Karishma, Otieno Fredrick, Shah Reena
Department of Medicine, Aga Khan University Hospital, Nairobi, Kenya.
Case Rep Med. 2020 Jan 5;2020:4385286. doi: 10.1155/2020/4385286. eCollection 2020.
Kikuchi-Fujimoto disease (KFD) is a rare form of painful lymphadenopathy, usually cervical, which is more common in Southeast Asia and rarely reported from Africa. Symptoms are usually nonspecific (fever, night sweats, etc.), and can mimic more common diseases such as tuberculosis (TB) in endemic areas. We report a case of a 29-year-old black African woman who was admitted with headache, neck pain, fever, and lymphadenopathy. She was found to have aseptic meningitis, eventually attributed to TB based on cervical node biopsy, although further histology suggested KFD. Blood tests for systemic lupus erythematosus (SLE) were negative; she had already been commenced on anti-TB treatment and had responded well and so was continued with this therapy. She was also later diagnosed with Hashimoto's thyroiditis 3 months after her diagnosis of KFD. Five months after stopping TB treatment, she was readmitted with the same symptoms and associated painless lymphadenopathy. Repeat biopsy was morphologically similar to that of 2017, and repeat evaluation confirmed SLE. She has since been managed by a rheumatologist and continues to do well.
菊池-藤本病（KFD）是一种罕见的疼痛性淋巴结病，通常累及颈部淋巴结，在东南亚更为常见，在非洲鲜有报道。症状通常不具特异性（发热、盗汗等），在流行地区可能类似结核病（TB）等更常见的疾病。我们报告一例29岁的非洲黑人女性病例，该患者因头痛、颈部疼痛、发热和淋巴结病入院。她被诊断为无菌性脑膜炎，最终根据颈部淋巴结活检结果归因于结核病，尽管进一步的组织学检查提示为菊池-藤本病。系统性红斑狼疮（SLE）的血液检查结果为阴性；她已经开始接受抗结核治疗，且反应良好，因此继续接受该治疗。在被诊断为菊池-藤本病3个月后，她后来还被诊断出患有桥本甲状腺炎。在停止抗结核治疗5个月后，她因相同症状及相关无痛性淋巴结病再次入院。重复活检在形态学上与2017年的相似，重复评估确诊为系统性红斑狼疮。此后她由一名风湿病学家进行治疗，目前情况良好。
