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菊池-藤本病:一例进展为狼疮性肾炎的病例报告。

Kikuchi-Fujimoto Disease: Report of a Case with Progression to Lupus Nephritis.

作者信息

Hurtado-Díaz Jorge, Espinoza-Sánchez María Lucero, Rojas-Milán Eduardo, Cimé-Aké Erik, de Los Ángeles Macias María, Romero-Ibarra Lizeth, Vera-Lastra Olga Lidia

机构信息

Department of Internal Medicine, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico.

Department of Pathological Anatomy, High Specialty Medical Unit, Specialty Hospital, Dr. Antonio Fraga Mouret, La Raza National Medical Center, México City, Mexico.

出版信息

Am J Case Rep. 2021 Mar 7;22:e927351. doi: 10.12659/AJCR.927351.

Abstract

BACKGROUND Kikuchi-Fujimoto disease (KFD) is an enigmatic disease, with a distinctive histopathology and a benign and self-limited course. It is more frequent in young Asian women. Autoimmune diseases are identified as one of its triggers; primarily SLE, which may precede, be concomitant with, or develop after the diagnosis of KFD. Patients with KFD should receive periodic follow-up for several years to detect possible evolution of SLE. The main feature of KFD is lymphadenopathy, and cervical lymph nodes are involved in 50% to 98% of cases. Other symptoms such as fever, fatigue, weight loss, and arthralgias are also reported. Differential diagnosis between KFD and SLE is a challenge. When KFD and SLE coexist, a lymph node biopsy may be diagnostic. Treatment should be symptomatic with analgesics and anti-inflammatories, with complete resolution in 3 to 4 months. Corticosteroids and immunosuppressive therapy are justified only in cases concomitant with SLE. CASE REPORT We report a case of KFD in a 28-year-old woman who was initially negative for anti-nuclear antibodies (ANA) and anti-double-stranded deoxyribonucleic acid antibodies (anti-dsDNA), but who became antibody-positive and presented with lupus nephritis 2 months later. CONCLUSIONS We present a case of a patient with KFD who developed SLE 2 months later; highlighting the importance of recognizing its association and its possible progression to monitor for future development of SLE and provide timely treatment to avoid complications. We also compared the clinical, laboratory, and histological similarities between the 2 entities.

摘要

背景 菊池-藤本病(KFD)是一种神秘的疾病,具有独特的组织病理学表现,病程呈良性且自限性。在年轻亚洲女性中更为常见。自身免疫性疾病被认为是其触发因素之一;主要是系统性红斑狼疮(SLE),它可能在KFD诊断之前、与之同时出现或在诊断之后发生。KFD患者应接受数年的定期随访,以检测SLE可能的演变情况。KFD的主要特征是淋巴结病,50%至98%的病例累及颈部淋巴结。还报告了其他症状,如发热、疲劳、体重减轻和关节痛。KFD与SLE之间的鉴别诊断具有挑战性。当KFD和SLE共存时,淋巴结活检可能具有诊断意义。治疗应以使用镇痛药和抗炎药进行对症治疗,3至4个月内可完全缓解。仅在合并SLE的情况下使用皮质类固醇和免疫抑制疗法才合理。病例报告 我们报告一例28岁女性的KFD病例,该患者最初抗核抗体(ANA)和抗双链脱氧核糖核酸抗体(抗dsDNA)为阴性,但2个月后抗体呈阳性并出现狼疮性肾炎。结论 我们报告了一例KFD患者在2个月后发展为SLE的病例;强调了认识其关联以及其可能进展的重要性,以便监测SLE的未来发展并及时治疗以避免并发症。我们还比较了这两种疾病在临床、实验室和组织学方面的相似之处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bfb/7949488/335197f2c602/amjcaserep-22-e927351-g001.jpg

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