Kikuchi-Fujimoto disease presenting as pyrexia of unknown origin

Background: Kikuchi-Fujimoto disease, a benign self-limited lymphadenopathy is an uncommon cause of pyrexia of unknown origin (PUO). Methods: We retrospectively studied the case-records of 13 patients presenting with PUO who were diagnosed to have Kikuchi-Fujimoto disease on peripheral lymph node excision biopsy and report the salient clinical manifestations and histopathological findings in them. All of them received symptomatic treatment. Results: Their median age was 28 [interquartile range (IQR) 18.5-38.0] years. Women (11/13, 84.6%) were more frequently affected. All of them were human immunodeficiency virus (HIV) seronegative. Prior to presenting to us, two were being treated for lymph node tuberculosis with DOTS. Cervical lymph nodes were predominantly involved, the distribution being: right cervical (n=10, 76.9%); left cervical (n=4); and bilateral cervical (n=2). Axillary and generalized lymphadenopathy were rare being seen in 2 and 1 patient respectively. The median (IQR) erythrocyte sedimentation rate (n=11) was 53 (35-89) mm at the end of first hour. Salient histopathological features were paracortical patchy zones of eosinophilic fibrinoid necrosis with karyorrhectic debris, large numbers of histiocytes, including histiocytes with peripherally placed “crescentic” nuclei. Spontaneous regression of fever and lymphadenopathy was observed over a median (IQR) period of 8 (6.75-10.25) months in all of them. Conclusions: Kikuchi-Fujimoto disease is a rare but important cause of PUO presenting with peripheral lymphadenopathy. Women are most often affected and cervical lymph nodes are the most frequently involved site. Clinical suspicion and thoughtful collaboration between clinicians and pathologists are essential for accurate diagnosis, and to minimize unnecessary investigations and inappropriate aggressive treatment

Large-scale genome-wide association analysis of bipolar disorder identifies a new susceptibility locus near ODZ4.

International audienceWe conducted a combined genome-wide association study (GWAS) of 7,481 individuals with bipolar disorder (cases) and 9,250 controls as part of the Psychiatric GWAS Consortium. Our replication study tested 34 SNPs in 4,496 independent cases with bipolar disorder and 42,422 independent controls and found that 18 of 34 SNPs had P < 0.05, with 31 of 34 SNPs having signals with the same direction of effect (P = 3.8 × 10(-7)). An analysis of all 11,974 bipolar disorder cases and 51,792 controls confirmed genome-wide significant evidence of association for CACNA1C and identified a new intronic variant in ODZ4. We identified a pathway comprised of subunits of calcium channels enriched in bipolar disorder association intervals. Finally, a combined GWAS analysis of schizophrenia and bipolar disorder yielded strong association evidence for SNPs in CACNA1C and in the region of NEK4-ITIH1-ITIH3-ITIH4. Our replication results imply that increasing sample sizes in bipolar disorder will confirm many additional loci

THE NEW INDUSTRIAL STATE AND CONVERGENCE: ANTECEDENTS IN MARX

The idea of convergence took a blow with the demise of the USSR and another with widely diverging economic performance of the US and communist China amid the pandemic. In this short contribution, I explore how James Galbraith and George Tsagolov handle this problem with very different arguments. I then show that, if we were to trace the longer lineage of the ideas of convergence and the new industrial state to Marx and Engels, we can vindicate them more fully and thoroughly than either attempt.</jats:p