Kikuchi disease differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Kikuchi disease}} | {{Kikuchi disease}} | ||
{{CMG}} | {{CMG}} ; {{AE}} {{MIR}} | ||
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==Differentiating Kikuchi disease from other Diseases== | ==Differentiating Kikuchi disease from other Diseases== | ||
Kikuchi disease is a rare, [[self-limiting]] [[disorder (medicine)|disorder]] that typically affects the [[cervical lymph nodes]]. Recognition of this condition is crucial, especially because it can easily be mistaken for | Kikuchi disease is a rare, [[self-limiting]] [[disorder (medicine)|disorder]] that typically affects the [[cervical lymph nodes]]. Recognition of this condition is crucial, especially because it can easily be mistaken for: | ||
*[[Disseminated tuberculosis]] | *[[Disseminated tuberculosis]] | ||
*[[Lymphoma]] | *[[Lymphoma]] | ||
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'''ANA:''' [[Anti-nuclear antibody|Antinuclear antibody]], '''RF:''' [[Rheumatoid factor]], '''Anti-CCp:''' [[Anti-citrullinated protein antibody|Anti-cyclic citrullinated protein antibody]], '''Anti U1RNP:''' Anti-U1 ribonucleoprotein antibodies , '''Anti Sm :''' Anti-Sm antibodies, '''Anti Ro:''' Anti Ro antibody also called anti-Sjögren's-syndrome-related antigen A antibody, '''Anti-dsDNA:''' [[Anti-dsDNA antbodies|Anti-double stranded DNA]]. | '''ANA:''' [[Anti-nuclear antibody|Antinuclear antibody]], '''RF:''' [[Rheumatoid factor]], '''Anti-CCp:''' [[Anti-citrullinated protein antibody|Anti-cyclic citrullinated protein antibody]], '''Anti U1RNP:''' Anti-U1 ribonucleoprotein antibodies , '''Anti Sm :''' Anti-Sm antibodies, '''Anti Ro:''' Anti Ro antibody also called anti-Sjögren's-syndrome-related antigen A antibody, '''Anti-dsDNA:''' [[Anti-dsDNA antbodies|Anti-double stranded DNA]]. | ||
</span> | </span> | ||
< | <small> | ||
{| class="wikitable" | {| class="wikitable" | ||
! colspan="2" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease | ! colspan="2" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease | ||
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! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti Ro | ! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti Ro | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti-dsDNA | ! align="center" style="background:#4479BA; color: #FFFFFF;" |Anti-dsDNA | ||
|- | |||
| colspan="2" align="center" style="background:#DCDCDC;" |[[Kikuchi's Disease|Kikuchi’s disease]]<ref name="pmid16538388">{{cite journal |vauthors=Kucukardali Y, Solmazgul E, Kunter E, Oncul O, Yildirim S, Kaplan M |title=Kikuchi-Fujimoto Disease: analysis of 244 cases |journal=Clin. Rheumatol. |volume=26 |issue=1 |pages=50–4 |year=2007 |pmid=16538388 |doi=10.1007/s10067-006-0230-5 |url=}}</ref> | |||
| - | |||
|<nowiki>+/-</nowiki> | |||
| - | |||
| - | |||
|medium and large joints | |||
|↑/↓ | |||
| - | |||
| - | |||
| - | |||
| - | |||
| - | |||
| - | |||
| - | |||
|Transient skin [[rashes]], [[malar rash]], [[Macule|erythematous macules]], patches, [[papules]], or [[plaques]] | |||
|May be associated with SLE | |||
|- | |- | ||
| colspan="2" align="center" style="background:#DCDCDC;" |[[Systemic lupus erythematosus]]<ref name="pmid25074031">{{cite journal |vauthors=Ehmke TA, Cherian JJ, Wu ES, Jauregui JJ, Banerjee S, Mont MA |title=Treatment of osteonecrosis in systemic lupus erythematosus: a review |journal=Curr Rheumatol Rep |volume=16 |issue=9 |pages=441 |year=2014 |pmid=25074031 |doi=10.1007/s11926-014-0441-8 |url=}}</ref> | | colspan="2" align="center" style="background:#DCDCDC;" |[[Systemic lupus erythematosus]]<ref name="pmid25074031">{{cite journal |vauthors=Ehmke TA, Cherian JJ, Wu ES, Jauregui JJ, Banerjee S, Mont MA |title=Treatment of osteonecrosis in systemic lupus erythematosus: a review |journal=Curr Rheumatol Rep |volume=16 |issue=9 |pages=441 |year=2014 |pmid=25074031 |doi=10.1007/s11926-014-0441-8 |url=}}</ref> | ||
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|Recurrent and usually painful [[mucocutaneous]] ulcers, [[Acneiform eruption|acneiform]] [[lesions]], papulo-vesiculo-[[Pustular rash|pustular]] eruptions, superficial [[thrombophlebitis]] | |Recurrent and usually painful [[mucocutaneous]] ulcers, [[Acneiform eruption|acneiform]] [[lesions]], papulo-vesiculo-[[Pustular rash|pustular]] eruptions, superficial [[thrombophlebitis]] | ||
|Male dominancy | |Male dominancy | ||
|- | |- | ||
| colspan="2" align="center" style="background:#DCDCDC;" |[[Serum sickness]]<ref name="pmid3564980">{{cite journal |vauthors=Kunnamo I, Kallio P, Pelkonen P, Viander M |title=Serum-sickness-like disease is a common cause of acute arthritis in children |journal=Acta Paediatr Scand |volume=75 |issue=6 |pages=964–9 |year=1986 |pmid=3564980 |doi= |url=}}</ref> | | colspan="2" align="center" style="background:#DCDCDC;" |[[Serum sickness]]<ref name="pmid3564980">{{cite journal |vauthors=Kunnamo I, Kallio P, Pelkonen P, Viander M |title=Serum-sickness-like disease is a common cause of acute arthritis in children |journal=Acta Paediatr Scand |volume=75 |issue=6 |pages=964–9 |year=1986 |pmid=3564980 |doi= |url=}}</ref> | ||
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|Rare in adults, [[Fifth disease|fifth's disease]] in children | |Rare in adults, [[Fifth disease|fifth's disease]] in children | ||
|} | |} | ||
</small> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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{{WS}} | {{WS}} | ||
[[Category:Rare diseases]] | [[Category:Rare diseases]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
Latest revision as of 18:07, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
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Differentiating Kikuchi disease from other Diseases
Kikuchi disease is a rare, self-limiting disorder that typically affects the cervical lymph nodes. Recognition of this condition is crucial, especially because it can easily be mistaken for:
Awareness of this disorder will help prevent misdiagnosis and inappropriate treatment.[1]
Differentiating Kikuchi disease from other diseases that may cause arthritis and rash
Abbreviations: ANA: Antinuclear antibody, RF: Rheumatoid factor, Anti-CCp: Anti-cyclic citrullinated protein antibody, Anti U1RNP: Anti-U1 ribonucleoprotein antibodies , Anti Sm : Anti-Sm antibodies, Anti Ro: Anti Ro antibody also called anti-Sjögren's-syndrome-related antigen A antibody, Anti-dsDNA: Anti-double stranded DNA.
| Disease | Arthritis | Auto-antibodies | Raynaud phenomenon | Rash pattern | Distinguishing/specific features | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Polyarthritis | Tenderness | Edema | Deformity /Erosion | Pattern | ANA | RF | Anti-CCp | Anti U1RNP | Anti Sm | Anti Ro | Anti-dsDNA | |||||
| Kikuchi’s disease[2] | - | +/- | - | - | medium and large joints | ↑/↓ | - | - | - | - | - | - | - | Transient skin rashes, malar rash, erythematous macules, patches, papules, or plaques | May be associated with SLE | |
| Systemic lupus erythematosus[3] | + | + | + | - | Small joints | ↑ | - | - | - | ↑ | ↑ | - | + | Malar rash and photosensitivity | ||
| Rheumatoid arthritis (RA)[4] | + | + | + | + | Small and large joints | - | ↑↑ | ↑↑ | - | - | - | - | + | Subcutaneous nodules | Erosive arthropathy | |
| Rhupus[5] | + | + | + | + | Small and large joints | ↑ | ↑ | ↑ | ↑ | ↑ | - | ↑ | + | Malar rash and photosensitivity | Erosive arthropathy | |
| Mixed connective tissue disease (MCTD)[6] | - | - | - | + | Small and large joints | - | ↑↑ | ↑ | - | - | - | - | + | Cutaneous eruptions, gottron’s papules, photodistributed erythema, poikiloderma, and calcinosis cutis | Overlapping features of SLE, systemic sclerosis (SSc), and polymyositis (PM) that lead to more than one diagnosis | |
| Undifferentiated connective tissue disease (UCTD)[7] | + | - | - | - | Lower extremity | ↑ | ↑ | - | - | ↑ | - | - | + | Erythematous macules, patches, or papules with delicate scale | Multiple connective tissue diseases with no enough criteria for a single diagnosis | |
| Systemic sclerosis (SSc)[8] | +/- | + | + | +/- | Lower extremity | ↑↑ | - | - | - | ↑ | - | ↑ | + | Hyperkeratosis, edema, and erythema | Sclerodactyly, Telangiectasias, Calcinosis, Malignant hypertension, acute renal failure | |
| Sjögren’s syndrome[9] | +/- | +/- | - | - | Lower extremity, axiallary creases | ↑ | - | - | - | ↑ | ↑ | - | - | Xerosis, scaly skin, annular erythema | Keratoconjunctivitis sicca | |
| Vasculitis | Giant cell[10] | - | + | + | - | Distal extremity | - | - | - | - | - | - | - | - | Rare | Involvement of cranial branches of arteries, visual loss |
| Takayasu[11] | - | +/- | +/- | - | Transient extremity | - | - | - | - | - | - | - | Erythema nodosum, pyoderma gangrenosum | Absent or weak peripheral pulse | ||
| Poly-arteritis nodosa[12] | - | +/- | - | - | General and mild | - | - | - | - | - | - | - | Tender erythematous nodules, purpura, livedo reticularis, bullous or vesicular eruption | Testicular pain or tenderness and neuropathies | ||
| Behçet’s syndrome[13] | +/- | +/- | +/- | - | medium and large joints | - | - | - | - | - | - | - | - | Recurrent and usually painful mucocutaneous ulcers, acneiform lesions, papulo-vesiculo-pustular eruptions, superficial thrombophlebitis | Male dominancy | |
| Serum sickness[14] | + | + | +/- | - | General | - | - | - | - | - | - | - | - | Pruritic rash, urticaria and/or serpiginous macular rash | Self-limited | |
| Psoriatic arthritis[15] | - | - | - | - | Small and large joints | - | - | - | - | - | - | - | - | Psoriasis and onychodystrophy | Dactylitis (sausage digits) | |
| Human parvovirus B19 infection[16] | + | + | - | - | Small joints | - | - | - | - | - | - | - | - | Erythematous rashes | Rare in adults, fifth's disease in children | |
References
- ↑ Rammohan A, Cherukuri SD, Manimaran AB, Manohar RR, Naidu RM (2012). "Kikuchi-Fujimoto Disease: A Sheep in Wolf's Clothing". J Otolaryngol Head Neck Surg. 41 (3): 222–226. PMID 22762705. Unknown parameter
|month=ignored (help) - ↑ Kucukardali Y, Solmazgul E, Kunter E, Oncul O, Yildirim S, Kaplan M (2007). "Kikuchi-Fujimoto Disease: analysis of 244 cases". Clin. Rheumatol. 26 (1): 50–4. doi:10.1007/s10067-006-0230-5. PMID 16538388.
- ↑ Ehmke TA, Cherian JJ, Wu ES, Jauregui JJ, Banerjee S, Mont MA (2014). "Treatment of osteonecrosis in systemic lupus erythematosus: a review". Curr Rheumatol Rep. 16 (9): 441. doi:10.1007/s11926-014-0441-8. PMID 25074031.
- ↑ Lee DM, Weinblatt ME (2001). "Rheumatoid arthritis". Lancet. 358 (9285): 903–11. doi:10.1016/S0140-6736(01)06075-5. PMID 11567728.
- ↑ Panush RS, Edwards NL, Longley S, Webster E (1988). "'Rhupus' syndrome". Arch. Intern. Med. 148 (7): 1633–6. PMID 3382309.
- ↑ Cappelli S, Bellando Randone S, Martinović D, Tamas MM, Pasalić K, Allanore Y, Mosca M, Talarico R, Opris D, Kiss CG, Tausche AK, Cardarelli S, Riccieri V, Koneva O, Cuomo G, Becker MO, Sulli A, Guiducci S, Radić M, Bombardieri S, Aringer M, Cozzi F, Valesini G, Ananyeva L, Valentini G, Riemekasten G, Cutolo M, Ionescu R, Czirják L, Damjanov N, Rednic S, Matucci Cerinic M (2012). ""To be or not to be," ten years after: evidence for mixed connective tissue disease as a distinct entity". Semin. Arthritis Rheum. 41 (4): 589–98. doi:10.1016/j.semarthrit.2011.07.010. PMID 21959290.
- ↑ Alarcón GS, Williams GV, Singer JZ, Steen VD, Clegg DO, Paulus HE, Billingsley LM, Luggen ME, Polisson RP, Willkens RF (1991). "Early undifferentiated connective tissue disease. I. Early clinical manifestation in a large cohort of patients with undifferentiated connective tissue diseases compared with cohorts of well established connective tissue disease". J. Rheumatol. 18 (9): 1332–9. PMID 1757934.
- ↑ LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA, Rowell N, Wollheim F (1988). "Scleroderma (systemic sclerosis): classification, subsets and pathogenesis". J. Rheumatol. 15 (2): 202–5. PMID 3361530.
- ↑ Roguedas AM, Misery L, Sassolas B, Le Masson G, Pennec YL, Youinou P (2004). "Cutaneous manifestations of primary Sjögren's syndrome are underestimated". Clin. Exp. Rheumatol. 22 (5): 632–6. PMID 15485020.
- ↑ Bablekos GD, Michaelides SA, Karachalios GN, Nicolaou IN, Batistatou AK, Charalabopoulos KA (2006). "Pericardial involvement as an atypical manifestation of giant cell arteritis: report of a clinical case and literature review". Am. J. Med. Sci. 332 (4): 198–204. PMID 17031245.
- ↑ Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE (1977). "Takayasu's arteritis. Clinical study of 107 cases". Am. Heart J. 93 (1): 94–103. PMID 12655.
- ↑ Pagnoux C, Seror R, Henegar C, Mahr A, Cohen P, Le Guern V, Bienvenu B, Mouthon L, Guillevin L (2010). "Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database". Arthritis Rheum. 62 (2): 616–26. doi:10.1002/art.27240. PMID 20112401.
- ↑ Tunç R, Uluhan A, Melikoğlu M, Ozyazgan Y, Ozdoğan H, Yazici H (2001). "A reassessment of the International Study Group criteria for the diagnosis (classification) of Behçet's syndrome". Clin. Exp. Rheumatol. 19 (5 Suppl 24): S45–7. PMID 11760398.
- ↑ Kunnamo I, Kallio P, Pelkonen P, Viander M (1986). "Serum-sickness-like disease is a common cause of acute arthritis in children". Acta Paediatr Scand. 75 (6): 964–9. PMID 3564980.
- ↑ Oriente P, Biondi-Oriente C, Scarpa R (1994). "Psoriatic arthritis. Clinical manifestations". Baillieres Clin Rheumatol. 8 (2): 277–94. PMID 8076388.
- ↑ Kaufmann J, Buccola JM, Stead W, Rowley C, Wong M, Bates CK (2007). "Secondary symptomatic parvovirus B19 infection in a healthy adult". J Gen Intern Med. 22 (6): 877–8. doi:10.1007/s11606-007-0173-9. PMC 2219874. PMID 17384979.