Korean J Pain.  2012 Jul;25(3):188-190. 10.3344/kjp.2012.25.3.188.

A Patient with Kikuchi's Disease: What Should Pain Clinicians Do?

• Park KE
• Kang S
• Ok SH
• Shin IW
• Sohn JT
• Chung YK
• Lee HK

• KMID: 2278154
• DOI: http://doi.org/10.3344/kjp.2012.25.3.188

Abstract

Kikuchi's disease (KD) is an idiopathic and self-limiting necrotizing lymphadenitis that predominantly occurs in young females. It is common in Asia, and the cervical lymph nodes are commonly involved. Generally, KD has symptoms and signs of lymph node tenderness, fever, and leukocytopenia, but there are no reports on treatment for the associated myofacial pain. We herein report a young female patient who visited a pain clinic and received a trigger point injection 2 weeks before the diagnosis of KD. When young female patients with myofascial pain visit a pain clinic, doctors should be concerned about the possibility of KD, which is rare but can cause severe complications.

Keyword

Kikuchi's disease; myofascial pain syndrome; neck pain; necrotizing lymphadenitis; pain clinic

MeSH Terms

Asia
Facial Pain
Female
Fever
Histiocytic Necrotizing Lymphadenitis
Humans
Leukopenia
Lymph Nodes
Lymphadenitis
Myofascial Pain Syndromes
Neck Pain
Pain Clinics
Trigger Points

Figure

• 

  Fig. 1 Axial computed tomography (CT) showing several lymph nodes (<1.8 cm) with internal necrosis below the right side of the sternocleidomastoid muscle.

Reference

1. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes: a clinicopathological study. Nihon Ketsueki Gakkai Zasshi. 1972; 35:379–380.

2. Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis. A new clinicopathological entity. Naika. 1972; 30:920–927.

3. Bosch X, Guilabert A, Miquel R, Campo E. Enigmatic Kikuchi-Fujimoto disease: a comprehensive review. Am J Clin Pathol. 2004; 122:141–152. PMID: 15272543.

4. Chung PS, Lee SJ, Yoon JS, Park SJ, Kim JS, Moon JH. Clinical and radiologic characteristics of Kikuchi's disease. Korean J Otolaryngol-Head Neck Surg. 2006; 49:85–89.

5. Hong KH, Kim KM, Park JH. A clinical study of histiocytic necrotizing lymphadenitis (Kikuchi's disease). Korean J Otolaryngol-Head Neck Surg. 1999; 42:490–494.

6. Lee HS, Tae K, Jang KJ, Lee EJ, Kim SK. Clinical characteristics of subacute necrotizing lymphadenitis. Korean J Otolaryngol-Head Neck Surg. 1998; 41:640–646.

7. Atwater AR, Longley BJ, Aughenbaugh WD. Kikuchi's disease: case report and systematic review of cutaneous and histopathologic presentations. J Am Acad Dermatol. 2008; 59:130–136. PMID: 18462833.

8. García CE, Girdhar-Gopal HV, Dorfman DM. Kikuchi-Fujimoto disease of the neck. Update. Ann Otol Rhinol Laryngol. 1993; 102:11–15. PMID: 8420463.

9. Silva AF, Focaccia R, Oliveira AC, Sementilli A, Reis GF. Kikuchi-Fujimoto disease: an unusual association with acute renal failure. Braz J Infect Dis. 2010; 14:621–627. PMID: 21340304.

10. Kampitak T. Fatal Kikuchi-Fujimoto disease associated with SLE and hemophagocytic syndrome: a case report. Clin Rheumatol. 2008; 27:1073–1075. PMID: 18465190.

11. Kwon SY, Kim TK, Kim YS, Lee KY, Lee NJ, Seol HY. CT findings in Kikuchi disease: analysis of 96 cases. AJNR Am J Neuroradiol. 2004; 25:1099–1102. PMID: 15205157.