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Shadrach BJ, Raju LP, Bibi A, Deokar K, Gaikwad P, Doshi J. Human papilloma virus vaccine induced Kikuchi-Fujimoto disease: A case report. Lung India 2025; 42:256-259. [PMID: 40296399 PMCID: PMC12097663 DOI: 10.4103/lungindia.lungindia_557_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 01/06/2025] [Accepted: 01/17/2025] [Indexed: 04/30/2025] Open
Abstract
ABSTRACT Cervical lymphadenopathy can be due to numerous causes. The common causes include reactive and infections conditions in children and malignancy in the elderly. Kikuchi-Fujimoto disease (KFD) is a rare cause of cervical lymphadenopathy. As viral vaccines contain viral antigens, they can trigger the development of KFD. The human papillomavirus (HPV) vaccine can trigger KFD. It is important to elicit a history of prior vaccination to identify the trigger in patients with necrotising histiocytic lymphadenitis suspected of having KFD. We hereby report a case of a 16-year-old female who was diagnosed with HPV vaccine induced KFD. Ours is the first case to be reported from India. Histopathology revealed necrotising histiocytic lymphoid hyperplasia and the absence of neutrophils, eosinophils, plasma cells, vessel wall vasculitis, haematoxylin bodies, and Reed-Sternberg cells, and negative aerobic, MTB cultures, anti-nuclear antibodies, clinched the diagnosis of KFD.
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Affiliation(s)
- Benhur Joel Shadrach
- Department of Pulmonary Medicine, Dr. Rela Institute and Medical Center, Chennai, Tamil Nadu, India
| | - Lexmi Priya Raju
- Department of Pathology, Dr. Rela Institute and Medical Center, Chennai, Tamil Nadu, India
| | - Asma Bibi
- Department of Haematopathology, Dr. Rela Institute and Medical Center, Chennai, Tamil Nadu, India
| | - Kunal Deokar
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Priyanka Gaikwad
- Department of Pediatrics, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Jinish Doshi
- General Physician, Doshi Clinic, Rajkot, Gujarat, India
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2
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Grewal S, Jawad AS. Recurrence of Kikuchi-Fujimoto Disease following influenza vaccination, diagnosis aided using ultrasound examination. Rheumatol Adv Pract 2024; 8:rkae104. [PMID: 39233786 PMCID: PMC11374019 DOI: 10.1093/rap/rkae104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2024] [Indexed: 09/06/2024] Open
Affiliation(s)
- Simran Grewal
- Department of Rheumatology, Royal London Hospital, London, UK
| | - Ali S Jawad
- Department of Rheumatology, Royal London Hospital, London, UK
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3
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Kularathna MDSV, Medagama A, Bandara R, Yasarathna D, Dilani MKI, Anuththara T. Kikuchi disease complicated with aseptic meningitis following COVID-19 Vaccination: a case report. J Med Case Rep 2024; 18:270. [PMID: 38840233 PMCID: PMC11155001 DOI: 10.1186/s13256-024-04541-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/10/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Kikuchi Fujimoto disease is a rare self-limiting disorder mainly affecting young Asian females. The typical presentation is unexplained fever with associated cervical lymphadenopathy. It can mimic many sinister diseases such as lymphoma, tuberculosis, and systemic lupus erythematosus. Aseptic meningitis due to Kikuchi disease is extremely rare, and majority were reported from Japan. There have been no published cases of aseptic meningitis due to Kikuchi disease in Sri Lanka. CASE PRESENTATION A 29 years old Sri Lankan female presented with a prolonged fever for three weeks with an associated headache for five days duration. She developed painful cervical lymphadenopathy during the hospital stay. She has been previously well and had been vaccinated against COVID-19 six weeks before. Her lumbar puncture showed lymphocytic pleocytosis with marginally elevated protein levels and reduced ratio of serum to CSF sugar. Lymph node biopsy was consistent with necrotizing lymphadenitis. She was subsequently diagnosed with Kikuchi disease complicated with aseptic meningitis. She responded to corticosteroids well and had an uneventful recovery. CONCLUSION Kikuchi disease is a rare self-limiting disorder that can be complicated with aseptic meningitis on infrequent occasions. Other conditions such as tuberculosis, lymphoma, systemic lupus erythematosus, and adult-onset Still's disease should be considered as differential diagnoses. Knowledge of Kikuchi disease and its complications will prevent unnecessary investigations which delay the early diagnosis and treatment.
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Caputo A, Caleo A, Cozzolino I, Zeppa P, Ciancia G, Ciliberti V. COVID-19 post-vaccination lymphadenopathy: A review of the use of fine needle aspiration cytology. Cytopathology 2023; 34:423-432. [PMID: 36807950 DOI: 10.1111/cyt.13221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/20/2023]
Abstract
COVID-19 vaccine-associated clinical lymphadenopathy (C19-LAP) and subclinical lymphadenopathy (SLDI), which are mainly detected by 18F-FDG PET-CT, have been observed after the introduction of RNA-based vaccines during the pandemic. Lymph node (LN) fine needle aspiration cytology (FNAC) has been used to diagnose single cases or small series of SLDI and C19-LAP. In this review, clinical and LN-FNAC features of SLDI and C19-LAP are reported and compared to non-Covid (NC)-LAP. A search for studies on C19-LAP and SLDI histopathology and cytopathology was performed on PubMed and Google Scholar, on 11 January 2023. Reports on LN-FNAC of C19-LAP were retrieved. A total of 14 reports, plus one unpublished case of C19-LAP observed in our institution, diagnosed by LN-FNAC were included in a pooled analysis and compared to the corresponding histopathological reports. In total, 26 cases were included in this review, with a mean age of 50.5 years. Twenty-one lymphadenopathies assessed by LN-FNAC were diagnosed as benign, and three cases as atypical lymphoid hyperplasia; the latter were subsequently confirmed as benign (one by repetition of LN-FNAC, two by histological control). One case of mediastinal lymphadenopathy in a patient suffering from melanoma was reported as reactive granulomatous inflammation, while one unsuspected case was diagnosed as metastasis from melanoma. In all cases, the cytological diagnoses were confirmed by follow-up or excisional biopsy. The high diagnostic value of LN-FNAC in excluding malignant processes was extremely useful in this context and may be particularly valuable when CNB or histological excisions are difficult to perform, as was the case during Covid lockdowns.
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Affiliation(s)
- Alessandro Caputo
- UOC di Anatomia Patologica, Azienda Ospedaliera Universitaria, San Giovanni di Dio e Ruggi d'Aragona, University of Salerno (IT), Salerno, Italy
| | - Alessia Caleo
- UOC di Anatomia Patologica, Azienda Ospedaliera Universitaria, San Giovanni di Dio e Ruggi d'Aragona, University of Salerno (IT), Salerno, Italy
| | - Immacolata Cozzolino
- Dipartimento di Salute Mentale e Fisica e Medicina, Università degli studi della Campania Luigi Vanvitelli, Naples (IT), Naples, Italy
| | - Pio Zeppa
- UOC di Anatomia Patologica, Azienda Ospedaliera Universitaria, San Giovanni di Dio e Ruggi d'Aragona, University of Salerno (IT), Salerno, Italy
| | - Giuseppe Ciancia
- UOC di Anatomia Patologica, Azienda Ospedaliera Universitaria, San Giovanni di Dio e Ruggi d'Aragona, University of Salerno (IT), Salerno, Italy
| | - Valeria Ciliberti
- UOC di Anatomia Patologica, Azienda Ospedaliera Universitaria, San Giovanni di Dio e Ruggi d'Aragona, University of Salerno (IT), Salerno, Italy
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5
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Craig JW, Farinha P, Jiang A, Lytle A, Skinnider B, Slack GW. Kikuchi-Fujimoto Disease Following COVID-19 Vaccination: Experience at a Population-Based Referral Center. Am J Clin Pathol 2023; 160:114-118. [PMID: 37526500 DOI: 10.1093/ajcp/aqad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/03/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES Multiple case reports describe Kikuchi-Fujimoto disease (KFD) following COVID-19 vaccination, but the true nature of this phenomenon is unknown. The purpose of this study was to further assess the relationship between KFD and COVID-19 vaccination at the population level. METHODS Confirmed KFD cases from January 2018 to April 2022 were identified from provincial pathology archives and analyzed in the context of vaccination statistics from public health resources. RESULTS Our statistical models provide evidence of a temporal association between KFD and both antecedent COVID-19 vaccine administration as well as age-stratified vaccination rates. Eight new cases of plausible COVID-19 vaccine-associated KFD are presented, collectively exhibiting clinical and pathologic features that overlap substantially with those of idiopathic KFD. CONCLUSIONS Our findings indicate that KFD is observed in association with COVID-19 vaccination and suggest that mechanistic studies are warranted.
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Affiliation(s)
- Jeffrey W Craig
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Pedro Farinha
- Centre for Lymphoid Cancer and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Aixiang Jiang
- Centre for Lymphoid Cancer and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Andrew Lytle
- Centre for Lymphoid Cancer and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, Canada
| | - Brian Skinnider
- Centre for Lymphoid Cancer and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Graham W Slack
- Centre for Lymphoid Cancer and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
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Mahajan VK, Sharma V, Sharma N, Rani R. Kikuchi-Fujimoto disease: A comprehensive review. World J Clin Cases 2023; 11:3664-3679. [PMID: 37383134 PMCID: PMC10294163 DOI: 10.12998/wjcc.v11.i16.3664] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/29/2023] [Accepted: 04/27/2023] [Indexed: 06/02/2023] Open
Abstract
Kikuchi-Fujimoto disease, a rare form of necrotizing lymphadenitis, is an uncommon, benign, self-limiting disorder of obscure etiology. It affects mostly young adults of both genders. Clinically, it presents with fever and lymphadenopathy of a firm to rubbery consistency frequently involving cervical lymph nodes while weight loss, splenomegaly, leucopenia, and elevated erythrocyte sedimentation rate feature in severely affected patients. Cutaneous involvement occurs in about 30%-40% of cases as facial erythema and nonspecific erythematous papules, plaques, acneiform or morbilliform lesions of great histologic heterogeneity. Both Kikuchi-Fujimoto disease and systemic lupus erythematosus share an obscure and complex relationship as systemic lupus erythematosus may occasionally precede, develop subsequently, or sometimes be associated concurrently with Kikuchi-Fujimoto disease. It is often mistaken for non-Hodgkin lymphoma while lupus lymphadenitis, cat-scratch disease, Sweet's syndrome, Still's disease, drug eruptions, infectious mononucleosis, and viral or tubercular lymphadenitis are other common differentials. Fine needle aspiration cytology mostly has features of nonspecific reactive lymphadenitis and immunohistochemistry studies usually show variable features of uncertain diagnostic value. Since its diagnosis is exclusively from histopathology, it needs to be evaluated more carefully; an early lymph node biopsy will obviate the need for unnecessary investigations and therapeutic trials. Its treatment with systemic corticosteroids, hydroxychloroquine, or antimicrobial agents mostly remains empirical. The article reviews clinicoepidemiological, diagnostic, and management aspects of KFD from the perspective of practicing clinicians.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. Radhakrishnan Government Medical College, Hamirpur 177001, Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. Radhakrishnan Government Medical College, Hamirpur 177001, Himachal Pradesh, India
| | - Neeraj Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. Radhakrishnan Government Medical College, Hamirpur 177001, Himachal Pradesh, India
| | - Ritu Rani
- Department of Dermatology, Venereology and Leprosy, Dr. Radhakrishnan Government Medical College, Hamirpur 177001, Himachal Pradesh, India
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Abstract
A previously healthy Japanese woman in her 20s was admitted to our hospital with a 2-week history of fever (39.0°C) and a 1-week history of painful cervical lymphadenopathy. The day before fever onset, she had received her first Pfizer-BioNTech SARS-CoV-2 vaccine in her left arm. She had previously been treated with empirical antibiotics with no improvement. Physical examination revealed painful lymphadenopathy in both posterior cervical regions. CT showed symmetrical lymphadenopathies in the neck, supraclavicular, axillary and inguinal regions as well as hepatosplenomegaly. We suspected lymphoma and performed a lymph node biopsy in the right inguinal region, which revealed necrotising histiocytic lymphadenitis. The patient was, therefore, diagnosed with Kikuchi-Fujimoto disease (KFD). She improved after the corticosteroid therapy. This report highlights the importance of including KFD as a differential diagnosis of lymphadenopathy after SARS-CoV-2 vaccination. Additionally, lymph node biopsy is helpful for diagnosing KFD because it rules out other entities.
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Affiliation(s)
- Kohsuke Ikeda
- Department of General Medicine, Tottori Municipal Hospital, Tottori, Japan
| | - Eiichi Kakehi
- Department of General Medicine, Tottori Municipal Hospital, Tottori, Japan
| | - Seiji Adachi
- Department of General Medicine, Tottori Municipal Hospital, Tottori, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Mohseni Afshar Z, Tavakoli Pirzaman A, Liang JJ, Sharma A, Pirzadeh M, Babazadeh A, Hashemi E, Deravi N, Abdi S, Allahgholipour A, Hosseinzadeh R, Vaziri Z, Sio TT, Sullman MJM, Barary M, Ebrahimpour S. Do we miss rare adverse events induced by COVID-19 vaccination? Front Med (Lausanne) 2022; 9:933914. [PMID: 36300183 PMCID: PMC9589063 DOI: 10.3389/fmed.2022.933914] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused many complications, the invention of coronavirus disease 2019 (COVID-19) vaccines has also brought about several adverse events, from common side effects to unexpected and rare ones. Common vaccine-related adverse reactions manifest locally or systematically following any vaccine, including COVID-19 vaccines. Specific side effects, known as adverse events of particular interest (AESI), are unusual and need more evaluation. Here, we discuss some of the most critical rare adverse events of COVID-19 vaccines.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Jackson J. Liang
- Division of Cardiovascular Medicine, Cardiac Arrhythmia Service, University of Michigan, Ann Arbor, MI, United States
| | - Akanksha Sharma
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, United States
| | - Marzieh Pirzadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Erfan Hashemi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadaf Abdi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Amirreza Allahgholipour
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rezvan Hosseinzadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Vaziri
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Terence T. Sio
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, United States
| | - Mark J. M. Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Mohammad Barary
- Student Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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9
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Kashiwada T, Saito Y, Terasaki Y, Shirakura Y, Shinbu K, Tanaka T, Tanaka Y, Seike M, Gemma A. Kikuchi-Fujimoto disease can present as delayed lymphadenopathy after COVID-19 vaccination. Hum Vaccin Immunother 2022; 18:2071080. [PMID: 35583472 PMCID: PMC9481093 DOI: 10.1080/21645515.2022.2071080] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Following COVID-19 vaccination, ipsilateral axillary and cervical lymphadenopathy may occur, called vaccine-related hypermetabolic lymphadenopathy, which is considered reactive lymphadenopathy. We report here a case of Kikuchi-Fujimoto disease, which occurred three months after vaccination with COVID-19 vaccine. The patient had cervical and axillary lymph node enlargement and a short-term fever that resolved spontaneously after the first and second vaccines. On the 90th day after the first vaccination, the patient developed a high fever and pathologically diagnosed necrotizing lymphadenitis in the axilla, which was diagnosed as Kikuchi-Fujimoto disease. Gallium scintigraphy showed localized swelling and strong uptake in the ipsilateral axilla. It implies the possibility of Kikuchi-Fujimoto Disease in axillary drainage lymph nodes in association with COVID-19 vaccine. Although only a few cases have been reported so far, this case is novel because of its later onset and diagnosis based on pathological and gallium scintigraphy imaging findings.
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Affiliation(s)
- Takeru Kashiwada
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshinobu Saito
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yasuhiro Terasaki
- Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yukari Shirakura
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kaoruko Shinbu
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toru Tanaka
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yosuke Tanaka
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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Daghri S, Belmoufid N, Rami A, Al Bouzidi A, Bouanani N. Kikuchi-Fujimoto's Disease or Histiocytic Necrotizing Lymphadenitis Following mRNA COVID-19 Vaccination: A Rare Case. Cureus 2022; 14:e24155. [PMID: 35592214 PMCID: PMC9110038 DOI: 10.7759/cureus.24155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 11/18/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD), also known as necrotizing histiocytic lymphadenopathy, is a rare and benign lymph node disorder that mainly occurs in young women. It is clinically characterized by fever with tender and painful cervical lymphadenopathy mostly; however, all areas of lymph nodes can be involved. This disorder is often mistaken for malignant lymphoma or infection. The precise pathophysiology of KFD remains unknown, but it is theorized that it may be post-viral or associated with an autoimmune disease. The diagnosis is based on the histological analysis of the excised involved lymph node. The treatment is mainly supportive with favorable outcomes within a few weeks or months. In this case, we present a 24-year-old woman without a past medical history, who consulted for painful bilateral cervical lymphadenopathy associated with fever that has been evolving for one month following the coronavirus disease 2019 (COVID-19) vaccination. The initial diagnostic workup was performed and the diagnosis of KFD was confirmed based on the histopathological findings of the excised lymphadenopathy. Therapeutic management was based on oral corticosteroid treatment with clinical and radiological improvement after a few days without recurrence during follow-up. This article aims to report a rare case of KFD in a patient after receiving the messenger ribonucleic acid (mRNA)-based COVID-19 vaccine. Therefore, this case highlights the possible association between COVID-19 vaccination and KFD and this should be considered in the differential diagnosis.
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11
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Guan Y, Xia X, Lu H. Kikuchi-Fujimoto disease following vaccination against COVID-19. J Hematop 2022; 15:21-23. [PMID: 35284024 PMCID: PMC8896846 DOI: 10.1007/s12308-021-00477-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/09/2021] [Indexed: 01/06/2023] Open
Abstract
The purpose of this study is to explore the clinicopathological features of Kikuchi-Fujimoto disease (KFD) following vaccination against coronavirus disease 2019 (COVID-19). One case of KFD following vaccination against COVID-19 was examined clinically, histologically, and immunohistochemically. The patient was a 36-year-old Chinese man who suffered from fever and cervical lymph node swelling following simultaneous administration of the COVID-19 vaccine. The patient was diagnosed with KFD based on the histopathological findings of a lymph node core needle biopsy, and his fever and swelling resolved 2 months later without therapy. Although the exact pathogenesis of the development of KFD following immunization remains unknown, this information should be added to the list of potential triggers or factors associated with the development of KFD.
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Affiliation(s)
- Yingying Guan
- Department of Pathology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, Fujian China
| | - Xiao Xia
- Department of Pathology, Wuzhong People’s Hospital, Wuzhong, Ningxia China
| | - Huadong Lu
- Department of Pathology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, Fujian China
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12
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Tan HM, Hue SSS, Wee A, See KC. Kikuchi-Fujimoto Disease Post COVID-19 Vaccination: Case Report and Review of Literature. Vaccines (Basel) 2021; 9:1251. [PMID: 34835182 PMCID: PMC8624158 DOI: 10.3390/vaccines9111251] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022] Open
Abstract
With the rapid development of various coronavirus disease 2019 (COVID-19) vaccines in a bid to counter and contain the COVID-19 pandemic, unusual and uncommon side effects of COVID-19 vaccination have been increasingly reported in the literature. Ipsilateral lymphadenopathy is a fairly common side effect of vaccination of any kind, with its etiology most commonly related to reactive lymphadenopathy. However, Kikuchi-Fujimoto Disease (KFD) or necrotizing histiocytic lymphadenitis is rarely observed post-vaccination, with only one other case of KFD post COVID-19 vaccination reported to date. We report two more cases of KFD post COVID-19 vaccination in the Asian population, highlighting the clinical course and salient clinical, radiological and histologic findings. In addition, we provide a literature review of the existing cases of lymphadenopathy post COVID-19 vaccination with cytologic and/or histologic correlation.
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Affiliation(s)
- Hui Min Tan
- Department of Pathology, National University Hospital, Singapore 119074, Singapore; (H.M.T.); (S.S.-S.H.); (A.W.)
| | - Susan Swee-Shan Hue
- Department of Pathology, National University Hospital, Singapore 119074, Singapore; (H.M.T.); (S.S.-S.H.); (A.W.)
| | - Aileen Wee
- Department of Pathology, National University Hospital, Singapore 119074, Singapore; (H.M.T.); (S.S.-S.H.); (A.W.)
| | - Kay Choong See
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore 119074, Singapore
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13
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Soub HA, Ibrahim W, Maslamani MA, A. Ali G, Ummer W, Abu-Dayeh A. Kikuchi-Fujimoto disease following SARS CoV2 vaccination: Case report. IDCases 2021; 25:e01253. [PMID: 34395192 PMCID: PMC8352853 DOI: 10.1016/j.idcr.2021.e01253] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 07/30/2021] [Accepted: 08/09/2021] [Indexed: 10/31/2022] Open
Abstract
Kikuchi's disease (KD) also known as Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis was first described in 1972 independently by Kikuchi and Fujimoto et al. It is a benign self-limited condition of unknown etiology which usually presents with cervical lymphadenopathy or fever of unknown origin. The diagnosis of KFD is based on histopathologic examination of the involved lymph node, showing the presence of well-defined necrosis without granulocytic cells. There is no special treatment for KFD. However non-steroidal anti-inflammatory drugs or corticosteroids are required occasionally to control the associated systemic manifestations. The outcome of the disease is usually favorable with resolution of symptoms in most cases within one to four months. We report a case of Kikuchi-Fujimoto disease that occurred in a young Qatari male patient 10 days following receiving the first dose of BNT162b2 vaccine. Diagnosis was established by lymph node biopsy and recovery was complete after 10 days.
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Affiliation(s)
- Hussam Al Soub
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Wanis Ibrahim
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Gawahir A. Ali
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Waseem Ummer
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ala’ Abu-Dayeh
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
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Müller CSL, Vogt T, Becker SL. Kikuchi-Fujimoto Disease Triggered by Systemic Lupus Erythematosus and Mycoplasma pneumoniae Infection-A Report of a Case and a Review of the Literature. Am J Dermatopathol 2021; 43:202-208. [PMID: 32809980 DOI: 10.1097/dad.0000000000001764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT Kikuchi-Fujimoto disease (KFD) is a necrotizing histiocytic lymphadenitis that was described for the first time in 1972 in Japan. Its etiology is still not fully understood. It has been reported in association with many different agents, diseases, and triggering factors without any conclusive result. To the best of our knowledge, we report for the first time a case of KFD with systemic lupus erythematosus in a child in association with a polymerase chain reaction (PCR)-positive throat swab for Mycoplasma pneumoniae. Although difficult to prove, the acute M. pneumoniae infection might have served as a triggering event for the development of KFD in our case. We encourage further studies to investigate a potential relationship between KFD and M. pneumoniae, which should also use PCR-based testing for this pathogen in patients with KFD.
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Affiliation(s)
- Cornelia S L Müller
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Thomas Vogt
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg/Saar, Germany
- Swiss Tropical and Public Health Institute, Basel, Switzerland; and
- University of Basel, Basel, Switzerland
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Chong Y, Kang CS. Causative agents of Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis): a meta-analysis. Int J Pediatr Otorhinolaryngol 2014; 78:1890-7. [PMID: 25200851 DOI: 10.1016/j.ijporl.2014.08.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/13/2014] [Accepted: 08/13/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Kikuchi-Fujimoto disease (KFD) is a self-limiting disorder characterized by histiocytic necrotizing lymphadenitis in the cervical lymph nodes of young women. Although an infectious etiology has been postulated, a definitive causative agent has not been identified. The few dozens of published studies are limited by small sample size and poorly structured study designs. The purpose of this study is to evaluate the association of each infectious agent to KFD that has been studied. METHODS We performed metaanalysis using major electronic database (MEDLINE (PubMed), Cochrane library, Embase, Web of Science, NML gateway, LILACS, and Google Scholar). Cross-sectional studies on the positivity of each agent in clinicopathologically diagnosed KFD and normal controls by polymerase chain reaction (PCR) or in situ hybridization (ISH) were carefully retrieved. The included infectious agents were herpes simplex virus (HSV) type 1, 2, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus (EBV), human herpes virus (HHV) 6, 7, 8, parvovirus B19, human papilloma virus, hepatitis B virus, human T-lymphotropic virus 1, Brucella, and Bartonella henselae. RESULTS After an exclusion process of 2491 studies, five, two, four, two, two, and three studies on EBV-PCR, EBV-ISH, HHV6-PCR, HHV8-PCR, parvovirus B19-PCR and HHV7-PCR, respectively, were suitable for quantitative meta-analysis. CONCLUSION The most suspected pathogen, EBV was not associated to KFD than normal controls (odds ratio=0.28, p=0.005), while the HHV8 positivity was more likely to be associated (odds ratio=8.24, p=0.003) although it still needs further verification. None of other viruses was associated to KFD although the results are limited by small sample size. More studies with large sample size and strict sample selection criteria are necessary in future.
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Affiliation(s)
- Yosep Chong
- Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yongdeungpo-gu, Seoul 150-713, Republic of Korea
| | - Chang Suk Kang
- Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yongdeungpo-gu, Seoul 150-713, Republic of Korea.
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Pellegrino P, Carnovale C, Pozzi M, Antoniazzi S, Perrone V, Salvati D, Gentili M, Brusadelli T, Clementi E, Radice S. On the relationship between human papilloma virus vaccine and autoimmune diseases. Autoimmun Rev 2014; 13:736-41. [DOI: 10.1016/j.autrev.2014.01.054] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
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Characteristics of Kikuchi-Fujimoto disease in children compared with adults. Eur J Pediatr 2014; 173:111-6. [PMID: 23955486 DOI: 10.1007/s00431-013-2131-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 07/30/2013] [Indexed: 10/26/2022]
Abstract
Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting disease characterized by cervical lymphadenopathy. Although it was primarily thought to be a disease of young adults, it has been increasingly recognized in children. To define the characteristics of KFD in children, we reviewed the medical records of patients younger than 18 years of age who were diagnosed with KFD from 2001 to 2012 at Korea University Medical Center, as well as worldwide published reports of KFD. A total of 140 pediatric patients and 733 patients of all ages was analyzed. Compared to the female predominance found in adults (2:1), young boys were more commonly affected than young girls (1.4:1). Cervical lymphadenopathy was the most common clinical finding in children, as it was in adults. Lymphadenopathy was more likely to be tender (69 vs. 44 %, p < 0.001) but less generalized (1 vs. 8 %, p < 0.05) in children compared to adults. Fever (82 vs. 35 %, p < 0.001) and rash (10 vs. 4 %, p < 0.05) were observed in children more commonly than in adults. Leukopenia was observed in 50 and 38 % of children and adults, respectively. Rates of recurrence and association with autoimmune diseases in children were comparable to those of adults. Cervical lymphadenopathy was the most common clinical manifestation of KFD in all ages. While fever and rash were more common in children with KFD compared to adults, generalized lymphadenopathy was rarer.
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Kapoor S. Rare Complications of Kikuchi's Disease: Beyond Pain Control. Korean J Pain 2012; 25:281-2. [PMID: 23091693 PMCID: PMC3468809 DOI: 10.3344/kjp.2012.25.4.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 08/20/2012] [Indexed: 11/05/2022] Open
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