Carbamazepine-induced delayed-onset agranulocytosis in a case of bipolar disorder with Kikuchi’s disease

A 48-year-old man who is a known case of bipolar disorder was maintaining well on a combination of carbamazepine and quetiapine for 3 years until he developed fever, severe leucopenia and lymphadenopathy, along with significant loss of weight and appetite. A thorough investigation revealed Kikuchi’s disease as a likely histological diagnosis. Carbamazepine was discontinued and quetiapine was titrated for the management of psychiatric symptoms. The patient gradually made good recovery following discontinuation of carbamazepine and the diagnosis of drug-induced myelosuppression was retained. Clinicians need to be aware of the adverse effects of medications being used for long-term prophylaxis and other possible conditions that may change the course of drug effects.

Kikuchi’s Disease: A Case Report

A 30-year-old female attended in August 2019, presented with painful swelling in right upper neck and fever for 20 days. Biochemical and microbiological tests, and imaging studies were all inconclusive. Histopathology of the affected lymph nodes revealed consistent with Kikuchi’s disease. The Patient was treated properly and complete remission occurred within few weeks. It is a self-limiting idiopathic disease which can mimic several serious conditions such as TB, lymphoma, infectious mononucleosis and others. Bangladesh J Otorhinolaryngol; October 2019; 25(2): 125-127

Kikuchi-Fujimoto disease with multiple extra-nodal features - A clinical mimic

Extranodal involvement in Kikuchi’s disease is uncommon. A 31-year-old previously healthy Indian woman was admitted with high grade fever, multiple joint pain and skin rash for 3 weeks. She had negative anti-nuclear antibodies and had features of Kikuchi’s disease on lymph node biopsy. She also had multiple extranodal manifestations including erythematous maculopapular rash, symmetric polyarthritis and hepatosplenomegaly. Kikuchi’s disease with extranodal involvement can clinically mimic diseases like hematological malignancies, connective tissue disorders and certain infections. A lymph node biopsy plays a crucial role in making an accurate diagnosis by excluding other diseases. A discussion on the importance of differentiating Kikuchi’s disease from systemic lupus erythematosus is included.

Take a second look: it's Kikuchi’s disease! A case report and review of literature

Generalized lymphadenopathy is a common cause of concern for both patients and clinicians. Possible etiologies include infections, malignancies and autoimmune diseases. Kikuchi Fujimoto disease (KFD) is a hyperergic condition that presents with fever, lymphadenopathy and can include systemic involvement, thus being easily mistaken for the above-mentioned entities. We report the case of a previously healthy 18-year-old male who presented with a selflimiting generalized lymphadenopathy, high fevers, skin vasculitis and polyserositis. The lymph-node biopsy revealed a histiocytotic necrotizing lymphadenitis, suggestive of Kikuchi’s disease. This case emphasizes the importance of KFD in the differential diagnosis of lymphadenopathy, especially in young adults.

A Case of Kikuchi’s Disease Presenting with Fever and Lymphadenopathy

Kikuchi’s disease is a rare, benign, self-limiting disorder, characterized clinically by fever and regional lymphadenopathy. Histopathologic features of lymph nodes in Kikuchi’s disease are characteristic and permit differentiation of this benign condition from lymphomas, systemic lupus erythematosus and infectious lymphadenopathies. We report a female patient presenting with fever and tender cervical lymphadenopathy. An excisional biopsy of the lymph node reveale lymphadenitis, consistent with Kikuchi’s disease.TAJ 2012; 25: 81-83