Kikuchi's disease with multisystemic involvement and adverse reaction to drugs

Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, was initi ally described in Japan in 1972. In the following years, several series of cases involving patients of different ages, races, and geographic origins w ere reported, but pediatric reports have been rare. The etiology of KD is unknown, although a viral or autoimmune hypothesis ha s been suggested. The most frequent clinical manifestation consists of loca l or generalized adenopathy, although in some cases, it is associated with more general symptoms, multiorganic involvement, and diverse analytic chang es (leukopenia, elevated erythrocyte sedimentation rate, and C-reactive pro tein, as well as an increase of transaminases and serum lactic dehydrogrena se). Diagnosis is based on characteristic pathologic findings that permit differ entiation of this disease from lymphoma, systemic lupus erythematosus, and infectious lymphadenopathies, We present here the case of a 14-year-old boy who presented with severe sys temic manifestations and transient fulminant hepatic failure in response to treatment with antituberculosis drugs.