Kikuchi's Disease with Multisystemic Involvement and Adverse Reaction to Drugs Maria L
Kikuchi’s Disease With Multisystemic Involvement and Adverse Reaction to Drugs Maria L. Murga Sierra, MD*; Eva Vegas, MD*; Javier E. Blanco-Gonza´lez, MD*; Almudena Gonza´lez, MD‡; Pilar Martı´nez, MD‡; and Maria A. Calero, MD§ ABSTRACT. Kikuchi’s disease (KD), or histiocytic ne- 163 mg/dL. Biochemical analysis, coagulation, hepatic and renal crotizing lymphadenitis, was initially described in Japan functions, immunoglobulins, and complement count were normal in 1972. In the following years, several series of cases (Tables 1, 2). Rheumatoid factor, antinuclear antibodies, direct involving patients of different ages, races, and geo- Coombs test, and two Mantoux test results proved to be negative. graphic origins were reported, but pediatric reports have Multiple blood, urine, feces, sputum, and tissue culture results been rare. also were negative. Antibody titers against Epstein–Barr, cyto- megalovirus, hepatitis, HIV, and Parvovirus B19, and serum poly- The etiology of KD is unknown, although a viral or merase chain reaction for herpesvirus type 6 were negative as autoimmune hypothesis has been suggested. The most well, as were results of serologic tests for syphilis, Brucella, toxo- frequent clinical manifestation consists of local or gen- plasmosis, Leishmania, Rickettsia, Borrelia, and Bartonella henselae eralized adenopathy, although in some cases, it is asso- and quintana. ciated with more general symptoms, multiorganic in- Results of chest roentgenography, echocardiography, and bone volvement, and diverse analytic changes (leukopenia, scan were normal; an abdominal ultrasound examination detected elevated erythrocyte sedimentation rate, and C-reactive hepatosplenomegaly with uniform density and nephromegaly protein, as well as an increase of transaminases and se- with increased cortical echogenicity.
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