We report the case of a 26-year-old woman with no history of interest who, when she was previously well, began with mild odynophagia, vested fever acetaminophen up to 3 and malaise around.
No accompanying chills or sweat crisis
4-5 days later, there was the appearance of lymph nodes in both laterocervical areas, so he started treatment with amoxicillin, 500 mg/8 h, on his own without any improvement.
Physical examination revealed the presence of adenopathies in both laterocervical chains of medium consistency, round, non-adherent, 1-2 cm in diameter and painless.
No lymphadenopathy or organomegaly were observed.
No goiter or pressure pain on the thyroid region
The analytical study showed leukocytosis with lymphocytic predominance, with a VSG of 22 mm/h.
Liver function was preserved, there was no hypergammaglobulinemia and mantoux was negative.
The chest X-ray was normal.
Serology for the viruses studied was negative (anti-EBV, CMV, HIV, HTLV-1, HV-6, toxoplasma and loes).
In the immunological study: ANA: 1/40), antiDNA: 13.4 IU/ml (50), antiRNA: negative, ENA-RNP: 0.45 and anticardiolipin: negative.
Thyroid function was evaluated: T3: 1.31 mg/L (0.6-1.6), T4: 84 mg/L (46-93), TSH: 6.3 mU/L (<7), TGB (antithyroxin 2071).
Thyroid scintigraphy was normal.
The fever disappeared after 12 days, but not the lymph nodes that remained unchanged, so we proceeded to the biopsy of two lymph nodes in the middle zone of the right cervical chain diagnostic.
Histological examination was compatible with non-lymphocytic histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease.
In the follow-up control of thyroid function 5 months after the onset of symptoms, there was a decrease in the titer of thyroid antibodies (TGB: 7.6 U/mL; TPO: 870 U/mL).
Our diagnosis was subacute lymphocytic thyroiditis associated with Kikuchi disease.
