Cadório Maria João, Oliveira João, Gama João, Duarte Cátia
Rheumatology Department, Coimbra Local Health Unit, Coimbra, Portugal.
Anatomical Pathology Department, Coimbra Local Health Unit, Coimbra, Portugal.
Mod Rheumatol Case Rep. 2025 Jan 16;9(1):110-116. doi: 10.1093/mrcr/rxae058.
Kikuchi-Fujimoto Disease (KFD), also known as Kikuchi histiocytic necrotising lymphadenitis, is an extremely rare and benign condition that mostly affects young women. It is characterised by lymph node involvement with a predilection for the cervical region, commonly presenting with tender lymphadenopathy and a low-grade fever. The diagnosis requires excisional lymph node biopsy with immunohistochemical analysis. KFD is mostly self-limiting within a few weeks to months, with only some patients requiring symptomatic relief with non-steroidal anti-inflammatory drugs or corticosteroids, and a minority developing recurrent episodes of the disease. Importantly, it has been reported in association with systemic lupus erythematosus and, to a lesser extent, other immune-mediated inflammatory rheumatic diseases, such as Sjögren's syndrome, whose clinical presentation itself may include lymphadenopathy. In this paper, we present an unusual case of a woman with primary Sjögren syndrome (pSS) and a past medical history relevant for lymphoma, sarcoidosis, and thymoma, who later developed KFD, a particularly challenging diagnosis in this setting. We then performed a literature review of the association between KFD and pSS, gathering a total of 13 patients, and focusing epidemiological, clinical, and laboratory data.
菊池-藤本病(KFD),又称菊池组织细胞坏死性淋巴结炎,是一种极为罕见的良性疾病,主要影响年轻女性。其特征为淋巴结受累,好发于颈部区域,通常表现为压痛性淋巴结病和低热。诊断需要进行淋巴结切除活检及免疫组化分析。KFD大多在数周或数月内自限,仅有部分患者需要使用非甾体抗炎药或皮质类固醇进行症状缓解,少数患者会出现疾病复发。重要的是,已有报道称其与系统性红斑狼疮相关,在较小程度上还与其他免疫介导的炎性风湿性疾病相关,如干燥综合征,其临床表现本身可能包括淋巴结病。在本文中,我们报告了一例不寻常的病例,一名患有原发性干燥综合征(pSS)且有淋巴瘤、结节病和胸腺瘤病史的女性,后来患上了KFD,在这种情况下这是一个特别具有挑战性的诊断。然后我们对KFD与pSS之间的关联进行了文献综述,共收集了13例患者,并重点关注了流行病学、临床和实验室数据。