Kikuchi-Fujimoto disease associated optic neuropathy in an adolescent

Purpose: We present a case of Kikuchi-Fujimoto Disease (KFD) associated with bilateral optic neuropathy progressing to vision loss. Observations: A 17-year-old male was referred for bilateral optic nerve pallor. Eight years prior, he was diagnosed with KFD after workup for lymphadenopathy and treate...

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Main Authors: Justin H. Cheong, Zacharia Nayer, Jeffrey G. Odel
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:American Journal of Ophthalmology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451993624002524
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author Justin H. Cheong
Zacharia Nayer
Jeffrey G. Odel
author_facet Justin H. Cheong
Zacharia Nayer
Jeffrey G. Odel
author_sort Justin H. Cheong
collection DOAJ
description Purpose: We present a case of Kikuchi-Fujimoto Disease (KFD) associated with bilateral optic neuropathy progressing to vision loss. Observations: A 17-year-old male was referred for bilateral optic nerve pallor. Eight years prior, he was diagnosed with KFD after workup for lymphadenopathy and treated with prednisolone acutely followed by long-term Plaquenil. He had reduced vision shortly after the diagnosis of KFD. Visual acuity was 20/50 OD and 20/250 OS, with pinhole to 20/40 OD and 20/70 OS. Comprehensive laboratory workup for infectious and autoimmune etiologies, including systemic lupus erythematosus (SLE), were negative. Magnetic resonance imaging (MRI) showed bilateral optic nerve atrophy and atrophy of the optic chiasm. The patient trialed B-complex vitamins with no improvement and continued to worsen with acute decrease in vision to no light perception OD at three-year follow-up. Treatment remained supportive. Conclusions and Importance: This is a case of bilateral KFD-associated optic neuropathy in an adolescent. Unlike previously reported cases, the patient experienced acute vision loss rather than full recovery of visual acuity after treatment. Ophthalmologists should be aware of the rare but serious association of optic neuritis and KFD.
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spelling doaj-art-155e6beabca44f148dbc6bb244aef1c32025-08-20T02:43:20ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-03-013710224210.1016/j.ajoc.2024.102242Kikuchi-Fujimoto disease associated optic neuropathy in an adolescentJustin H. Cheong0Zacharia Nayer1Jeffrey G. Odel2Columbia University Vagelos College of Physicians and Surgeons, 104 Haven Avenue, New York, NY, 10032, USA; Corresponding author.Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USADepartment of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USAPurpose: We present a case of Kikuchi-Fujimoto Disease (KFD) associated with bilateral optic neuropathy progressing to vision loss. Observations: A 17-year-old male was referred for bilateral optic nerve pallor. Eight years prior, he was diagnosed with KFD after workup for lymphadenopathy and treated with prednisolone acutely followed by long-term Plaquenil. He had reduced vision shortly after the diagnosis of KFD. Visual acuity was 20/50 OD and 20/250 OS, with pinhole to 20/40 OD and 20/70 OS. Comprehensive laboratory workup for infectious and autoimmune etiologies, including systemic lupus erythematosus (SLE), were negative. Magnetic resonance imaging (MRI) showed bilateral optic nerve atrophy and atrophy of the optic chiasm. The patient trialed B-complex vitamins with no improvement and continued to worsen with acute decrease in vision to no light perception OD at three-year follow-up. Treatment remained supportive. Conclusions and Importance: This is a case of bilateral KFD-associated optic neuropathy in an adolescent. Unlike previously reported cases, the patient experienced acute vision loss rather than full recovery of visual acuity after treatment. Ophthalmologists should be aware of the rare but serious association of optic neuritis and KFD.http://www.sciencedirect.com/science/article/pii/S2451993624002524Kikuchi diseaseKikuchi-Fujimoto diseaseOptic neuritisOptic neuropathyHistiocytic necrotizing lymphadenitisSystemic lupus erythematosus
spellingShingle Justin H. Cheong
Zacharia Nayer
Jeffrey G. Odel
Kikuchi-Fujimoto disease associated optic neuropathy in an adolescent
American Journal of Ophthalmology Case Reports
Kikuchi disease
Kikuchi-Fujimoto disease
Optic neuritis
Optic neuropathy
Histiocytic necrotizing lymphadenitis
Systemic lupus erythematosus
title Kikuchi-Fujimoto disease associated optic neuropathy in an adolescent
title_full Kikuchi-Fujimoto disease associated optic neuropathy in an adolescent
title_fullStr Kikuchi-Fujimoto disease associated optic neuropathy in an adolescent
title_full_unstemmed Kikuchi-Fujimoto disease associated optic neuropathy in an adolescent
title_short Kikuchi-Fujimoto disease associated optic neuropathy in an adolescent
title_sort kikuchi fujimoto disease associated optic neuropathy in an adolescent
topic Kikuchi disease
Kikuchi-Fujimoto disease
Optic neuritis
Optic neuropathy
Histiocytic necrotizing lymphadenitis
Systemic lupus erythematosus
url http://www.sciencedirect.com/science/article/pii/S2451993624002524
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AT zacharianayer kikuchifujimotodiseaseassociatedopticneuropathyinanadolescent
AT jeffreygodel kikuchifujimotodiseaseassociatedopticneuropathyinanadolescent