J Clin Neurol.  2005 Apr;1(1):104-106. 10.3988/jcn.2005.1.1.104.

Aseptic Meningitis in Kikuchi's Disease

Affiliations
  • 1Department of Neurology, Wonkwang University College of Medicine, Sanbon Hospital, Gunpo, Korea. vcyang@wonkwang.ac.kr

Abstract

The involvement of the nervous system in Kikuchi's disease (KD) is rare. Although some reports of meningeal involvement in KD were described in the literature from Japan, it has rarely been reported in Korea. A 23-year-old man presented with severe headache, fever, and vomiting. Cerebrospinal fluid (CSF) analysis revealed an opening pressure 300 mmH2O, WBC 283/mm3, glucose 44 mg/dl and protein 86 mg/dl. Multiple tender lymph nodes on the left anterior neck were found on the 9th day of his hospital stay. The lymph node biopsy disclosed histopathologic features typical of KD. We report a patient with KD accompanied by aseptic meningitis, emphasizing the importance of recognizing this disorder in diagnosing patients with meningitis.

Keyword

Lymphadenitis; Nervous system; Aseptic meningitis

MeSH Terms

Biopsy
Cerebrospinal Fluid
Fever
Glucose
Headache
Histiocytic Necrotizing Lymphadenitis*
Humans
Japan
Korea
Length of Stay
Lymph Nodes
Lymphadenitis
Meningitis
Meningitis, Aseptic*
Neck
Nervous System
Vomiting
Young Adult
Glucose

Figure

  • Figure 1 Microscopic view of the left cervical lymph node biopsy specimen. The specimen shows many karyorrhectic debris with histiocytes and immunoblasts, but without neutrophils (H&E, ×1000).


Reference

1. Dorfman RF, Berry GJ. Kikuchi's histiocytic necrotizing lymphadenitis: an analysis of 108 cases with emphasis on differential diagnosis. Semin Diagn Pathol. 1988. 5:329–345.
2. Garcia CE, Girdhar-Gopal HV, Dorfman DM. Kikuchi-Fujimoto disease of the neck: update. Ann Otol Rhinol Laryngol. 1993. 102:11–15.
Article
3. Itoh H, Shimasaki S, Nakashima A, Ohsato K, Tokikuni N, Kitajima C. Sweet's syndrome associated with subacute necrotizing lymphadenitis. Intern Med. 1992. 31:686–689.
Article
4. Dorfman RF. Histiocytic necrotizing lymphadenitis of Kikuchi and Fujimoto. Arch Pathol Lab Med. 1987. 111:1026–1029.
5. Norris AH, Krasinskas AM, Salhany KE, Gluckman SJ. Kikuchi-Fujimoto disease: A benign cause of fever and lymphadenopathy. Am J Med. 1996. 101:401–405.
Article
6. Chan JK, Wong KC, Ng CS. A fatal case of multicentric Kikuchi\'s histiocytic necrotizing lymphadenitis. Cancer. 1989. 63:1856–1862.
Article
7. Rho NK, Choi SJ, Jeong CW, Lee ES. A case of Kikuchi's disease (histiocytic necrotizing lymphadenitis) with cutaneous involvement presenting as aseptic meningitis. Korean J Dermatol. 2001. 39:896–901.
8. Asano S, Akiake Y, Jinnouchi H, Muramatsu T, Wakasa H. Necrotizing lymphadenitis: a review of clinicopathological, immunohistochemical and ultrastructural studies. Hematol Oncol. 1990. 8:251–260.
Article
9. Sato Y, Kuno H, Oizumi K. Histiocytic necrotizing lymphadenitis (Kikuchi's disease) with aseptic meningitis. J Neurol Sci. 1999. 163:187–191.
Article
10. Debley JS, Rozansky DJ, Miller ML, Katz BZ, Greene ME. Histiocytic necrotizing lymphadenitis with autoimmune phenomena and meningitis in a 14-year-old Girl. Pediatrics. 1996. 98:130–133.
Article
11. Mathew LG, Cherian T, Srivastava VM, Raghupathy P. Histiocytic necrotizing lymphadenitis (Kikuchi's disease) with aseptic meningitis. Indian Pediatr. 1998. 35:775–777.
12. Atarashi K, Yoshimura N, Nodera H, Tsukimoto K, Beppu H, Kanayama M. Recurrent histiocytic necrotizing lymphadenitis (Kikuchi's disease) in an human T lymphotropic virus type I carrier. Intern Med. 1996. 35:821–825.
Article
13. Nagata A, Shoji H, Kaji M. A case of subacute necrotizing lymphadenitis with acute cerebellar ataxia. Rinsho Shinkeigaku. 1986. 26:354–357.
14. Sugiyama A, Araki E, Arakawa K, Kikuchi H, Iwaki T, Yamada T, et al. A case of subacute necrotizing lymphadenitis complicated with brachial plexus neuritis. Rinsho Shinkeigaku. 1998. 38:941–944.
15. Shafqat S, Memon SB, Hyder S, Hasan SH, Smego RA Jr. Brainstem encephalitis with Kikuchi-Fujimoto disease. J Coll Physicians Surg Pak. 2003. 13:663–664.
Full Text Links
  • JCN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr