Linfadenitis necrotizante asociada a Kikuchi Fujimoto; reporte de caso y revisión de la literatura

Abstract

A case is presented of a 21-year-old female patient with febrile ademic symptoms, skin rash predominantly in the cervical and thoracic region accompanied by painful generalized lymphadenopathy that initially simulated a diagnosis of infectious mononucleosis due to Epstein Bar virus, for which treatment with non-anti-inflammatory drugs was started. Due to the non-positive evolution, steroids are suspected in Non- Hodgkin's Lymphoma, the diagnosis of Kikuchi-Fujimoto disease is ruled out with histological study by excisional biopsy of the left supraclavicular lymph node. The favorable evolution stands out for being a self-limited benign disease, however it continues to be a paroxysmal entity of an important autoimmune disease, the patient develops Sjogren's Syndrome with extraglandular involvement 12 months after the initial diagnosis.

Kikuchi-Fujimoto disease is a rare entity characterized by subacute necrotizing lymphadenopathy, young adults of Asian descent are the most affected, characterized by the expansion of paracortical lymph nodes with patchy and well-defined areas of necrosis that show abundant nuclear remains. karyorrhexic and absence of neutrophils and eosinophils. There is a marked predominance of T cells in lesions with very few B cells. This pathology is associated with several autoimmune diseases, including systemic lupus erythematosus and Sjogren's syndrome.