|
|
| (12 intermediate revisions by 2 users not shown) |
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| | '''For patient information, click [[{{PAGENAME}} (patient information)|here]]''' |
| {{Infobox_Disease | | | {{Infobox_Disease | |
| Name = Kikuchi disease| | | Name = Kikuchi disease| |
| Image = Histiocytic necrotizing lymphadenitis.jpg| | | Image = Kikuchi disease.jpg| |
| Caption = [[Micrograph]] of a [[lymph node]] with Kikuchi disease showing the characteristic features (abundant [[histiocytes]], [[necrosis]] without [[neutrophil]]s) on [[H&E stain]].| | | Caption = [[Micrograph]] of a [[lymph node]] with Kikuchi disease showing the characteristic features (abundant [[histiocytes]], [[necrosis]] without [[neutrophil]]s) on [[H&E stain]].| |
| DiseasesDB = |
| |
| ICD10 = |
| |
| ICD9 = |
| |
| ICDO = |
| |
| OMIM = |
| |
| MedlinePlus = |
| |
| MeshID = D020042|
| |
| }} | | }} |
| {{SI}} | | {{Kikuchi disease}} |
| {{CMG}} | | {{CMG}} |
|
| |
|
| '''''Synonyms and keywords:''''' Histiocytic necrotizing lymphadenitis; Kikuchi-Fujimoto disease; Kikuchi necrotizing lymphadenitis; phagocytic necrotizing lymphadenitis; subacute necrotizing lymphadenitis; necrotizing lymphadenitis
| | {{SK}} Histiocytic necrotizing lymphadenitis; Kikuchi-Fujimoto disease; Kikuchi necrotizing lymphadenitis; phagocytic necrotizing lymphadenitis; subacute necrotizing lymphadenitis; necrotizing lymphadenitis |
|
| |
|
| ==Overview== | | ==[[Kikuchi disease overview|Overview]]== |
| '''Kikuchi's disease''' (histiocytic necrotizing lymphadenitis) is a rare, non-cancerous enlargement of the [[lymph node]]s: the diagnosis can be confirmed by lymph node biopsy. It was originally described in Japan by Dr M. Kikuchi in 1972.<ref>Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes. ''Acta Hematol Jpn'' 1972;35:379–80.<!--No PMID--></ref>
| | ==[[Kikuchi disease historical perspective|Historical Perspective]]== |
| ==Pathophysiology==
| | ==[[Kikuchi disease pathophysiology|Pathophysiology]]== |
| Some studies have suggested a genetic predisposition to the proposed autoimmune response. Several infectious candidates have been associated with Kikuchi's disease.<ref name="pmid18462833">{{cite journal |author=Atwater AR, Longley BJ, Aughenbaugh WD |title=Kikuchi's disease: case report and systematic review of cutaneous and histopathologic presentations |journal=J. Am. Acad. Dermatol. |volume=59 |issue=1 |pages=130–6 |year=2008 |month=July |pmid=18462833 |doi=10.1016/j.jaad.2008.03.012 |url=http://linkinghub.elsevier.com/retrieve/pii/S0190-9622(08)00300-9}}</ref>
| |
|
| |
|
| There are many postulates about the etiology of KFD. A microbial/viral or autoimmune cause has been suggested. Mycobacterium szulgai, Yesinia and Toxoplasma have been implicated. More recently there has been growing evidence of the role of Epstein-Barr virus, as well as other viruses (HHV6, HHV8, Parvovirus B19, HIV- and HTLV-1) in the pathogenesis of KFD. <ref name="PMID22762705">{{cite journal |author=Rammohan A, Cherukuri SD, Manimaran AB, Manohar RR, Naidu RM|title=Kikuchi-Fujimoto Disease: A Sheep in Wolf's Clothing |journal=J Otolaryngol Head Neck Surg|volume=41 |issue=3 |pages=222–226 |year=2012 |month=June|pmid=22762705|}}</ref> But serologic tests including antibodies to a host of viruses have consistently proven noncontributory and no viral particles have been identified ultrastructurally.
| | ==[[Kikuchi disease causes|Causes]]== |
| It is now proposed that KFD is a nonspecific hyperimmune reaction to a variety of infectious, chemical, physical and neoplastic agents. In addition to SLE, other autoimmune conditions and manifestations such as antiphospholipid syndrome, polymyositis, systemic juvenile idiopathic arthritis, bilateral uveitis, arthritis and cutaneous necrotizing vasculitis have been linked to KFD. It is possible that KFD may represent an exuberant T-cell mediated immune response in a genetically susceptible individual to a variety of non-specific stimuli. <ref name="PMID22762705">{{cite journal |author=Rammohan A, Cherukuri SD, Manimaran AB, Manohar RR, Naidu RM|title=Kikuchi-Fujimoto Disease: A Sheep in Wolf's Clothing |journal=J Otolaryngol Head Neck Surg|volume=41 |issue=3 |pages=222–226 |year=2012 |month=June|pmid=22762705|}}</ref>
| |
|
| |
|
| ==Causes== | | ==[[Kikuchi disease differential diagnosis|Differentiating Kikuchi disease from other Diseases]]== |
| *The cause for this disease has not been established.
| |
|
| |
|
| *Kikuchi's disease has been reported to be associated with infections such as:
| | ==[[Kikuchi disease epidemiology and demographics|Epidemiology and Demographics]]== |
| :*[[epstein-Barr virus]],
| |
| :*[[human herpesvirus 6]],
| |
| :*[[toxoplasmosis]], and
| |
| :*[[Human T-lymphotropic virus]]
| |
| ==Differentiating Kikuchi disease from other Diseases==
| |
| Kikuchi-Fujimoto disease (KFD) is a rare, self-limiting disorder that typically affects the cervical [[lymph node]]s. Recognition of this condition is crucial, especially because it can easily be mistaken for [[tuberculosis]], [[lymphoma]], or even [[adenocarcinoma]]. Awareness of this disorder will help prevent misdiagnosis and inappropriate treatment.<ref name="PMID22762705">{{cite journal |author=Rammohan A, Cherukuri SD, Manimaran AB, Manohar RR, Naidu RM|title=Kikuchi-Fujimoto Disease: A Sheep in Wolf's Clothing |journal=J Otolaryngol Head Neck Surg|volume=41 |issue=3 |pages=222–226 |year=2012 |month=June|pmid=22762705|}}</ref>
| |
|
| |
|
| ==Epidemiology and Demographics== | | ==[[Kikuchi disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| Kikuchi's disease is a very rare disease and mainly seen in Japan. Isolated cases are reported in America, Europe and Asia. It is mainly a disease of young adults (mean age, 20–30 years), with a slight bias towards females. | |
| ==Natural History==
| |
| Course of the disease is generally benign and self-limiting. Lymphadenopathy most often resolves over several weeks to six months. Recurrence rate is about 3%.
| |
| ==Prognosis==
| |
| *Kikuchi's disease is a self limiting illness.
| |
|
| |
|
| *In most reported cases, it is common for the debilitating symptoms to last for half a year; however, the disease does return to some patients after time.
| | ==Diagnosis== |
| | [[Kikuchi disease history and symptoms|History and Symptoms]] | [[Kikuchi disease physical examination|Physical Examination]] | [[Kikuchi disease laboratory findings|Laboratory Findings]] | [[Kikuchi disease chest x ray|Chest X Ray]] | [[Kikuchi disease CT|CT]] | [[Kikuchi disease MRI|MRI]] | [[Kikuchi disease ultrasound|Ultrasound]] | [[Kikuchi disease other diagnostic studies|Other Diagnostic Studies]] |
|
| |
|
| *Mortality is extremely rare and usually due to [[hepatic]], [[respiratory]], or [[cardiac failure]].
| | ==Treatment== |
| ==Clinical presentation== | | [[Kikuchi disease medical therapy|Medical Therapy]] | [[Kikuchi disease surgery|Surgery]] | [[Kikuchi disease cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Kikuchi disease future or investigational therapies|Future or Investigational Therapies]] |
| The clinical presentation is very similar symptoms to [[Hodgkin's lymphoma]] which has led to the misdiagnosis of some patients and resulting in dangerous cancer treatment to those suffering from Kikuchi's disease.
| |
| | |
| ====Symptoms====
| |
| The symptoms of Kikuchi's are the following:
| |
| | |
| * [[Lymphadenopathy]]
| |
| * Drenching night sweats
| |
| * [[Fever]]
| |
| * Bone-joint pain
| |
| * [[Loss of appetite]]
| |
| * Unexplained [[weight loss]]
| |
| * General weakness
| |
| * [[Fatigue]]
| |
| * Mental unfocus
| |
|
| |
|
| ==Treatment== | | ==Case Studies== |
| *The cause for this disease has not been established, and there is also no cure.
| | [[Kikuchi disease case study one|Case #1]] |
| *Kikuchi's patients are able to treat some symptoms and wait weeks to months before the symptoms of Kikuchi's has been suppressed.
| |
|
| |
|
| ==Related chapters== | | ==Related Chapters== |
| *For other causes of lymph node enlargement, see [[lymphadenopathy]]. | | *For other causes of lymph node enlargement, see [[lymphadenopathy]]. |
|
| |
|
| ==References==
| |
| {{reflist|2}}
| |
|
| |
| {{Symptoms and signs}}
| |
|
| |
|
| |
| [[Category:Disease]]
| |
| [[Category:Infectious disease]]
| |
|
| |
|
| [[Category:Rare diseases]] | | [[Category:Rare diseases]] |
