Kikuchi's Disease Following Subaccute Thyroiditis

Abstract

Kikuchi's disease (KD) is a benign, self-limiting histiocytic necrotizing lymphadenitis. This disease is commonly confused with other diseases such as lymphoma, tuberculous lymphadenitis, and systemic lupus erythematosus or hemophagocytic syndrome. The viral infections are the strongly accused factors to cause cell apoptosis, and may be responsible for the necrosis of the lymph nodes. Many studies believe the viral agents and autoimmune are the causative factors of Kikuchi's disease.Thyroiditis is a group of thyroid inflammation disorder that may be painful and tender when caused by infection, radiation and trauma, or painless when caused by autoimmune conditions, medications or an idiopathic fibrotic process. It has been reported to be associated with glomerulonephritis, pregnancy, radiation and some autoimmune, connective tissue diseases.We present the case of a 25-year-old man with multiple right cervical lymphadenopathy, which diagnosed as Kikuchi's disease by pathology. Initially he had diffuse painful thyroid gland swelling only, which diagnosed as subacute granulomatous thyroiditis. Viral infection is usually believed to be the causative agent of acute upper respiratory tract infection, subacute granulomatous thyroiditis, Hashimoto's thyroiditis and Kikuchi’s disease. The coexistence of KD and transient thyroiditis following upper respiratory infection in our patient may support the viral infection to be the etiology.