Necrotizing lymphadenitis
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Rheumatologie Kasuistiken Z Rheumatol https://doi.org/10.1007/s00393-020-00929-6 Accepted: 27 October 2020 © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020 Redaktion M.O. Becker, Zürich P. Hoff, Berlin A.J. Hueber, Bamberg F. Moosig, Neumünster
Background Necrotizing lymphadenitis, also known as Kikuchi–Fujimoto disease, histiocytic necrotizing lymphadenitis or subacute necrotizing lymphadenitis, was first reported in Japan by M. Kikuchi and Fujimoto in 1972 [1, 2]. Although the disease has been reported worldwide, it is mainly reported in Asia and only occasionally reported in Europe and the United States. Due to its low incidence it is often misdiagnosed or missed entirely, so its true incidence is difficult to determine. However, it is identified in approximately 3–9% of lymph node biopsies [3]. It is a rare form of lymphadenitis and a non-neoplastic disease manifesting as lymph node enlargement, which is caused by reactive hyperplasia of lymph nodes [4]. The disease is most common in young women, especially those 10–30 years old, and is occasionally found in the elderly population [5]. Necrotizing lymphadenitis often involves the skin in addition to lymph nodes, and its first manifestation is usually enlarged lymph nodes in the neck accompanied by fever; hepatosplenomegalyhas beenreported in approximately 15% of patients [6]. The aetiology of necrotizing lymphadenitis is not clear, and acute viral infection is thought to play a role [7]. Since its epidemiological, clinical and histological features overlap with those of systemic lupus erythematosus (SLE), it is also considered to be related to autoimmunity [8]. There are also studies suggesting that it may be a precursor lesion of tumours, so
J. Huang1 · J.-X. Zheng2 · Y. Yang1 · D. Zhu1 1
Department of Rheumatology and Immunology, Daping Hospital, Army Medical University, Chongqing, China 2 Department of Rheumatology and Immunology, the Affiliated Hospital of North Sichuan Medical College, Nanchong, China
Necrotizing lymphadenitis A case report and literature review
phadenitis was ultimately confirmed by lymph node biopsy. The effect of shortterm glucocorticoid therapy was good, and there was no fever or lymph node pain during continuous follow-up for half a year. In this article, we compare this case with those in the relevant literature and summarize the clinical characteristics, treatment and management of necrotizing lymphadenitis. Our report will enable early recognition of this
patients with necrotizing lymphadenitis should be monitored closely to prevent future disease. In this case, a young woman presented to our clinic with fever and lymphadenopathy as her main clinical symptoms. Such symptoms led us to consider tuberculosis, lymphoma or connective tissue disease. However, after performing the relevant examinations, these diseases were excluded and necrotizing lymTable 1 Laboratory examination values Indicator Value
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Reference interval
Laboratory test RF-IgM
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