Tuberculosis Lymphadenitis in Association With Celiac Disease Mimicking Kikuchi-Fujimoto Disease

Kikuchi-Fujimoto disease (KFD) is an uncommon idiopathic self-limited cause of lymphadenitis that most commonly presents with cervical lymphadenopathy with or without systemic signs and symptom, which is also called histiocytic necrotizing lymphadenitis (1-6). Although infection and autoimmune etiology have been suggested, the cause of KFD is unknown. Several features that support a role for an infectious cause include the generally self-limited courses and association with symptoms similar to upper respiratory tract infection. Many viral infections have been proposed including cytomegalovirus, varicella zoster virus, human herpes virus, Epstein-Barr virus, parainfluenza virus, parvovirus B19, paramyxovirus, Yersinia enterocolitica, and Toxoplasma gondii. In a Korean study on 147 patients presenting at an outpatient clinic, KFD (34.7%) and tuberculous (TB) adenitis (22.4%) were the most common causes of cervical adenitis (7-14). We presented a case of TB lymphadenitis in association with celiac disease that mimicked KFD in a young child. Celiac disease, also known as gluten-sensitive enteropathy and nontropical sprue, is an autoimmune disease with chronic inflammation of small intestine, which is associated with increased risk of TB infection. TB lymphadenitis can mimic KFD. Therefore, in each case of unusual lymphadenitis, TB should be considered and if it is associated with failure to thrive, celiac disease should be suspected