Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis

Table 1

Laboratory results summarized from 2017 to 2019.

Variable	Reference range	Aug 2017	Sept 2017	Jan 2018	July 2018	Feb 2019
White blood cell	4–10 (10^9/L)	2.51	3.19			2.06
Neutrophil count	2–7 (10^9/L)	1.16	2.12			1.14
Lymphocyte count	1–3 (10^9/L)	1.10	0.81			0.80
Hemoglobin	11.5–16.5 (g/dl)	10.2	11			11
Platelet count	150–450 (10^9/L)	118	153			85
ESR (Erythrocyte sedimentation rate)	0–20 (mm/hr)		44			61
CRP (C-reactive protein)	0–5 (mg/l)	1.63	15.1
AST (aspartate transaminase)	0–35 (U/L)	22	23.5			33.4
ALT (alanine transaminase)	0–35 (U/L)	17.7	13.9			15.6
Creatinine	58–98 (micromol/l)	65	59			60
HIV Elisa		Neg	Neg		Neg
CSF:
Cell count	0–5 (mm^3)	31.25	295			<5
Neut	%	6	4
Lymph	%	94	96
Glucose	2.22–3.89 (mmol/l)	2.39	3.51			2.69
Protein	0.15–0.45 (g/l)	0.52	0.56			0.44
Tb Gene expert			Neg			Neg
CSF adenine deaminase	0–5 (U/L)		18.41			0.29
CSF culture		No growth	No growth			No growth
CSF viral PCR-herpes + enterovirus		Neg				Neg
EBV (Epstein-Barr virus)		IgG-positive IgM-neg
Tropical fever screen-; (i) Malaria antigen; (ii) Leptospira; (iii) Rickettsia; (iv) Dengue; (v) West Nile virus; (vi) Chikungunya		Neg				Neg
Malaria parasite		Absent	Absent
Blood culture		No growth				No growth
Urine culture		No growth				No growth
ANA (antinuclear antibody)			Neg			Positive 1 : 320 speckled
ENA						Positive for SS-A/RO-52
Complement 3/4						Normal
Anti-dsDNA			Neg			Neg
Antiphospholipid antibody						Neg
Direct Coombs test						Neg
Ferritin	13–150 (ng/ml)					Normal
Lipid profile						Normal
TSH (thyroid stimulating hormone)	0.27–4.2 (pg/ml)		1.68	49.77	25.24	4.23
T3	2–4.4 (pg/ml)		2.88	1.67	2.97	1.87
T4	0.97–1.58 (ng/ml)		0.87	0.32	0.84	0.86
Anti-TPO antibodies	<34 (IU/ml)				290
Antithyroglobulin	<115 (IU/ml)				226
TSH receptor antibodies	<1.22				0.468
Lymph node biopsy			Refer to Figures 1(a) and 1(b)			Refer to Figure 1(c)
Tissue Tb culture			Neg
Bone marrow aspirate						Normocellular