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http://dx.doi.org/10.21593/kjhno/2022.38.2.23

A Case of Systemic Lupus Erythematosus Presenting as Cervical Lymphadenopathy  

Hyun Seok, Kang (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Jae Seon, Park (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Tae Hwan, Kim (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Sang Hyuk, Lee (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Publication Information
Korean Journal of Head & Neck Oncology / v.38, no.2, 2022 , pp. 23-27 More about this Journal
Abstract
Systemic lupus erythematosus(SLE) is a multisystemic disorder of autoimmune etiology. SLE can occur commonly in young women, and the early symptoms include fever, myalgia, arthralgia, weight loss, lymphadenopathy and these nonspecific symptoms develop into skin rash, splenomegaly, serositis and encephalopathy. Diagnosis of SLE requires clinical and serologic criteria, and treatment choices are hydroxyquinolone and NSAIDs for mild disease, corticosteroids and immunosuppressant for severe disease. In lupus patient, the prevalence of lymphadenopathy is 12~59%. Although lymphadenopathy is common finding in SLE, it is hard to distinguish in early phase of SLE. A 38-year-old woman visited our hospital for cervical lymphadenopathy with polyarthritis and malaise. Multiple cervical lymph nodes enlargement was found on Neck CT, and serologic laboratory test including ANA, antiphospholipid antibody, and anti-dsDNA was positive. For excluding lymphoma, PET-CT and excisional biopsy were performed. The patient finally diagnosed with SLE, and got regular follow-up without complication.
Keywords
Autoimmune disease; Kikuchi's disease; Lymphadenopathy; SLE;
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1 Shim JS, Sung YK, Joo YB, Lee HS, Bae SC. Prevalence and incidence of systemic lupus erythematosus in South Korea. Rheumatol Int. 2014;34:909-917.   DOI
2 Campbell SM, Montanaro A, Bardana EJ. Head and neck manifestations of autoimmune disease. Am J Otolaryngol. 1983;4:187-216.   DOI
3 Dubois EL, Tuffanelli DL. Clinical manifestations of systemic lupus erythematosus: Computer analysis of 520 cases. JAMA. 1964;190:104-111.
4 Meyer O, Kahn M, Grossin M, Ribard P, Belmatoug N, Morinet F, et al. Parvovirus B19 infection can induce histiocytic necrotizing lymphadenitis (Kikuchi's disease) associated with systemic lupus erythematosus. Lupus. 1991;1:37-41.   DOI
5 Bae EH, Lim SY, Han KD, Jung JH, Choi HS, Kim HY, et al. Trend of prevalence and incidence of systemic lupus erythematosus in South Korea, 2005 to 2015: A nationwide population-based study. Korean J Intern Med. 2020;35:652-661.   DOI
6 Borchers AT, Keen CL, Shoenfeld Y, Gershwin ME. Surviving the butterfly and the wolf: Mortality trends in systemic lupus erythematosus. Autoimmun Rev. 2004;3:423-453.   DOI
7 Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes: A clinicopathological study. Acta Haematol Jpn. 1972;35:379-380.
8 Fujimoto Y. Cervical subacute necrotizing lymphadenitis. A new clinicopathological entity. Intern Med. 1972;20:920-927.
9 Bosch X, Guilabert A, Miquel R, Campo E. Enigmatic Kikuchi-Fujimoto disease: A comprehensive review. Am J Clin Pathol. 2004;122:141-152.
10 Dorfman R, Berry G. Kikuchi's histiocytic necrotizing lymphadenitis: An analysis of 108 cases with emphasis on differential diagnosis. Semin Diagn Pathol. 1988;5:329-345.
11 Dorfman R. Histiocytic necrotizing lymphadenitis of Kikuchi and Fujimoto. Arch Pathol Lab Med. 1987;111:1026-1029.
12 Martinez-Vazquez C, Hughes G, Bordon J, Alonso-Alonso J, Anibarro-Garcia A, Redondo-Martinez E, et al. Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto's disease, associated with systemic lupus erythemotosus. QJM. 1997;90:531-533.   DOI
13 Trager J, Ward MM. Mortality and causes of death in systemic lupus erythematosus. Curr Opin Rheumatol. 2001;13:345-351.   DOI
14 Imamura M, Ueno H, Matsuura A, Kamiya H, Suzuki T, Kikuchi K, et al. An ultrastructural study of subacute necrotizing lymphadenitis. J Psychopathol Clin Sci. 1982;107:292-299.
15 Hu S, Kuo TT, Hong HS. Lupus lymphadenitis simulating Kikuchi's lymphadenitis in patients with systemic lupus erythematosus: A clinicopathological analysis of six cases and review of the literature. Pathol Int. 2003;53:221-226.   DOI
16 Bosch X, Guilabert A. Kikuchi-Fujimoto disease. Orphanet J Rare Dis. 2006;1:1-3.   DOI
17 Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine. 2003;82:299-308.   DOI
18 Oglesby A, Korves C, Laliberte F, Dennis G, Rao S, Suthoff ED, et al. Impact of early versus late systemic lupus erythematosus diagnosis on clinical and economic outcomes. Appl Health Econ Health Policy. 2014;12:179-190.   DOI