SHM Converge Scientific Abstract ePoster Gallery-A Rare Presentation of a Rare Disorder: Kikuchi-Fujimoto Disease

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This case describes a 49-year-old woman with atrial fibrillation, prior cerebrovascular accident, and hypertension who presented with 3 days of worsening left-sided abdominal pain, along with nausea, anorexia, and one fever to 38.3°C. She had a similar admission 4 months earlier, when CT imaging showed diffuse nonspecific retroperitoneal and mesenteric lymphadenopathy that was not further evaluated. On this admission, repeat CT showed stable lymphadenopathy. Extensive laboratory testing was negative for infectious and autoimmune causes.<br /><br />Because of persistent unexplained lymphadenopathy, a retroperitoneal lymph node biopsy was performed. Pathology showed necrotizing lymphadenitis with lymphoid proliferation and foamy histiocytes, consistent with Kikuchi-Fujimoto disease (KFD). The patient was treated supportively, improved by hospital day 2, and was discharged without recurrence to date.<br /><br />KFD is a rare, usually self-limited lymphoproliferative disorder. It most commonly presents with fever and cervical lymphadenopathy, making this retroperitoneal presentation unusual. Its cause remains unclear, with proposed viral and autoimmune associations. The disease is important to recognize because it can mimic malignancy, infection, or systemic autoimmune disease, especially in patients with “red flag” symptoms such as fever and lymphadenopathy. Definitive diagnosis requires lymph node biopsy. Because KFD can recur and may coexist with systemic lupus erythematosus, outpatient monitoring and autoimmune testing such as ANA and dsDNA may be appropriate.<br /><br />Overall, this case highlights KFD as a rare but benign cause of stable lymphadenopathy and nonspecific abdominal symptoms, with symptom resolution after supportive care.

Asset Subtitle

Romy Portieles Pena

Meta Tag

Author List Arti Tewari, Romy Portieles Pena

Category Clinical Vignettes

Concept Kikuchi-Fujimoto disease

Concept Lymphadenopathy

Concept Lymph Node Biopsy

Concept Supportive Care

Concept Self-limited Course

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Romy Portieles Pena

Track Adult

Keywords

Kikuchi-Fujimoto disease

retroperitoneal lymphadenopathy

necrotizing lymphadenitis

abdominal pain

fever

lymph node biopsy

foamy histiocytes

supportive care

autoimmune testing

systemic lupus erythematosus

Kikuchi-Fujimoto disease

Lymphadenopathy

Lymph Node Biopsy

Supportive Care

Self-limited Course