I saw this young lady of 20 all worked up and shaking with fear; the family members in trail were equally anxious. The story goes that she went for some vague joint pains to a specialist. She had normal joints, though. All the tests that he ordered -- a long battery of them -- were all absolutely normal. Though the ESR was 3mm, when the normal for women under 50 is 20mm!
She went around shopping, thanks to her anxiety. The next doctor found some small but insignificant glands in her neck region. He got one of them biopsied and the report said Kikuchi disease which was immediately conveyed to the patient. The poor lady was happy that she got a diagnosis but was mortally afraid of the strange disease. Now, with malignant anxiety state, she started further medical shopping. She was further confused, until she came to me. In between, some doctor had doubted the biopsy report and put in a rider that it could be a mistaken diagnosis further compounding the issue, remotely suggesting that it could even be malignant!
What Is this Funny Disease?
Kikuchi disease, also called histolytic necrotising lymphadenitis or Kikuchi-Fujimoto disease, is an uncommon, idiopathic, generally self-limited cause of lymphadenitis. Kikuchi first described the disease in 1972 in Japan. Fujimoto and colleagues independently described Kikuchi disease in the same year.
Please mark the two vital features: 1) it is benign. 2) It is self-limiting and so does not require any treatment.
In that case, what was the need to generate such morbid anxiety in the innocent patient? That is why I say that we, medical professionals, generate anxiety many a time. I wonder if I have been able to douse that flame of anxiety in that girl or not but I can well imagine the gravity of her anxiety state! Poor thing. Many of our hapless patients take our word as gospel truth and then suffer the consequences. So, we must be very, very careful when we pronounce our judgement. May this article be a reminder to our careless colleagues. The moral of the story is that this girl would have been much happier without medical intervention. Life would have been easier and a lot of money saved. Let us put ourselves in her shoes and think -- empathy is the urgent need of the hour.