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Kikuchi-Fujimoto Disease Following COVID-19 Vaccination
Consuelo Carrillo - 2023-08-26 17:14:33
<div>Link to Medscape:&nbsp;https://www.medscape.com/s/viewarticle/995393</div>; <div>Posted on Medscape:&nbsp;Public Health, on August 25, 2023.</div> <div>&nbsp;</div> <div>Am J Clin Pathol.&nbsp;2023;160(2):114-118.&nbsp;</div> <div>Kikuchi-Fujimoto Disease Following COVID-19 Vaccination</div> <div>Experience at a Population-Based Referral Center</div> <div>Jeffrey W. Craig, MD, PhD; Pedro Farinha, MD, PhD; Aixiang Jiang, MS; Andrew Lytle, MD, PhD; Brian Skinnider, MD; Graham W. Slack, MD</div> <div>&nbsp;</div> <div>Abstract</div> <div> <p><strong>Objectives:</strong>&nbsp;Multiple case reports describe Kikuchi-Fujimoto disease (KFD) following COVID-19 vaccination, but the true nature of this phenomenon is unknown. The purpose of this study was to further assess the relationship between KFD and COVID-19 vaccination at the population level.</p> <p><strong>Methods:</strong>&nbsp;Confirmed KFD cases from January 2018 to April 2022 were identified from provincial pathology archives and analyzed in the context of vaccination statistics from public health resources.</p> <p><strong>Results:</strong>&nbsp;Our statistical models provide evidence of a temporal association between KFD and both antecedent COVID-19 vaccine administration as well as age-stratified vaccination rates. Eight new cases of plausible COVID-19 vaccine-associated KFD are presented, collectively exhibiting clinical and pathologic features that overlap substantially with those of idiopathic KFD.</p> <p><strong>Conclusions:</strong>&nbsp;Our findings indicate that KFD is observed in association with COVID-19 vaccination and suggest that mechanistic studies are warranted.</p> </div> <div>&quot;Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a benign and self-limited condition characterized by subacute necrotizing regional lymphadenopathy.[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 1);">1</a>]&nbsp;Although individuals of any age, sex, and race may be affected, most are young adults (typically &lt;40 years old) with a female predominance and a higher prevalence among Asians.[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 2);">2</a>,<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 3);">3</a>]&nbsp;Patients typically have tender posterior cervical, axillary, and/or supraclavicular lymphadenopathy, which is often accompanied by fever or other constitutional symptoms.[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 4);">4</a>]&nbsp;Laboratory findings are either normal or nonspecific and include mild anemia, leukopenia, and elevated serum inflammatory markers. <p>Despite extensive investigation, the underlying cause(s) of KFD remain uncertain. Numerous microbes have been proposed as possible etiologic agents, including the SARS-CoV-2 virus,[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 5.9);">5&ndash;9</a>]&nbsp;but a causal relationship has yet to be established.[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 10);">10</a>,<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 11);">11</a>]&nbsp;Prior to the COVID-19 pandemic, KFD had also been described as a rare side effect of vaccination against influenza,[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 12);">12</a>]&nbsp;human papillomavirus, and Japanese encephalitis virus.[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 13);">13</a>]&nbsp;Several recent case reports have also described KFD following COVID-19 vaccination,[<a href="javascript:void(0);" onclick="showToolTip(this, 'references', 14.19);">14&ndash;19</a>]&nbsp;but the magnitude and significance of this association are unclear.&quot;</p> </div> <div>&nbsp;</div>