A 17 years old girl with Kikuchi - Fujimoto disease ( KFD ) and severe leukopenia

Background: Kikuchi-Fujimoto disease (KFD) is an enigmatic, benign and self-limited syndrome characterized by regional lymphadenopathy with tenderness, usually accompanied by mild fever and night sweats. Patient: A 17 years old girl admitted in infectious diseases ward with chief complaint of fever and cervical lymphadenopathy since one week ago. Her problems started with fever and pharyngitis. Three days later, she developed one cervical lymphadenopathy. Blood sample revealed a WBC count of 1700 cells/mm, platelets count of 137000/mm. IgG-anti EBV antibody (VCA) level was 98.7 (upper limit of normal 20) and IgM-anti EBV antibody level was 52.7 (upper limit of normal 40). In hospital course her leukopenia became worse and reached 700cells/mm. After two weeks WBC count recovered, and reached 5100 cells/mm. Lymph node biopsy was achieved and showed necrotizing lymphadenitis with histiocytic reaction consistent with Kikuchi disease. Conclusion: Kikuchi-Fujimoto disease must be considered in differential diagnosis of patients with acute severe neutropenia.