Self-limiting COVID‐19-associated Kikuchi‐Fujimoto disease with heart involvement: case-based review

Abstract

Background The association between COVID-19 infection and the development of autoimmune diseases is currently unknown, but there are already reports presenting induction of different autoantibodies by SARS-CoV-2 infection. Kikuchi-Fuimoto disease (KFD) as a form of histiocytic necrotizing lymphadenitis of unknown origin. Objective Here we present a rare case of KFD with heart involvement after COVID-19 infection. To our best knowledge only a few cases of COVID-19-associated KFD were published so far. Based on presented case, we summarize the clinical course of KFD and its association with autoimmune diseases, as well we discuss the potential causes of perimyocarditis in this case. Methods We reviewed the literature regarding cases of “Kikuchi-Fujimoto disease (KFD)” and “COVID-19” and then “KFD” and “heart” or “myocarditis” by searching medical journal databases written in English in PubMed and Google Scholar. Results Only two cases of KFD after COVID infection have been described so far. Conclusion SARS-CoV-2 infection can also be a new, potential causative agent of developing KFD.

Kikuchi-Fujimoto Disease Following COVID-19 Infection in a 7-Year-Old Girl: A Case Report and Literature Review

“…More recently, six cases of KFD were described after COVID-19, the main features of which are listed in Table 2 [8][9][10][11][12][13]. This patient was the first school-aged child among the six reported cases of KFD after COVID-19 infection, with an age of onset ranging from 5 to 43 years.…”

Kikuchi–Fujimoto disease in a child who had a high suspicion of COVID-19 infection

“…Of them, three developed Kikuchi–Fujimoto disease after COVID-19 infection, and the remaining two developed Kikuchi–Fujimoto disease following COVID-19 vaccination. All reported cases were adolescents and young adults in contrast to our pediatric patient [ 1 , 2 ]. All cases showed complete resolution, similar to our case.…”

“…Although we could not demonstrate a positive SARS-CoV-2 PCR test, possible household contamination with COVID-19 infection and positive anti-SARS-CoV-2 antibody in addition to generalized lymphadenopathy all support the diagnosis of COVID-19 infection-associated Kikuchi–Fujimoto disease in our patient. Based on a literature review, Kikuchi–Fujimoto disease in association with COVID-19 has been described in five patients to date [ 1 , 2 ]. Of them, three developed Kikuchi–Fujimoto disease after COVID-19 infection, and the remaining two developed Kikuchi–Fujimoto disease following COVID-19 vaccination.…”

“…All cases showed complete resolution, similar to our case. In light of the reported cases, COVID-19 may be a potential cause of Kikuchi–Fujimoto disease [ 1 , 2 ]. Our experience suggests that histopathologic evaluation is important for distinguishing from malign diseases.…”

SARS-CoV-2-fertőzés okozta Kikuchi–Fujimoto-betegség sikeres gyógyítása

“…A betegség etiológiája, patogenezise mind a mai napig ismeretlen, ám elfogadott tény, hogy olyan immunválasz következtében alakul ki, melynek kiváltója lehet az Epstein-Barr-vírus, a humán herpeszvírus 6-os és 8-as formája, a HIV, a B19 parvovírus, Toxoplasma, Yersinia és a paromyxovirusok [11]. A SARS-CoV-2-fertőzés, illetve az ezt követően kialakult nyaki lymphadenopathia hátterében fennálló Kikuchi-Fujimoto-betegség ritka, ennek ellenére a COVID-19-pandémia megjelenése után a SARS-CoV-2-t a Kikuchi-Fujimoto-betegség kialakulása egyik kiváltó tényezőjeként tartják számon [12][13][14].…”