菊池-藤本病:一例白人青年发热及淋巴结病报告。

David Kellner, Tijana Temelkovska, Adela Greeley, Ashley Saito
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摘要

背景:菊池-藤本病(KFD)是一种罕见的原因,迅速发展的压痛性颈部淋巴结病。它最初常常被误诊并被当作传染性淋巴结炎处理。虽然大多数KFD病例是自限性的,并可通过退烧药和镇痛药得到改善,但有些病例更为难治性,可能需要皮质类固醇或羟氯喹治疗。病例介绍:一名27岁的白人男性,因发热和颈部淋巴结病疼痛而就诊。他在切除淋巴结活检中发现有KFD。他的症状很难用皮质类固醇治疗,但最终羟氯喹单药治疗得到改善。结论:KFD诊断不应考虑地理位置、种族或患者性别。肝脾肿大是KFD的一种相对罕见的表现,使其特别难以与淋巴增生性疾病(如淋巴瘤)区分。淋巴结活检是获得及时和明确诊断的首选诊断方法。虽然通常是自限性的,但KFD与自身免疫性疾病有关,包括系统性红斑狼疮。因此,确保KFD的诊断对于确保患者适当监测相关自身免疫性疾病的发展至关重要。
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Kikuchi-Fujimoto Disease: A Case Report of Fever and Lymphadenopathy in a Young White Man.

Background: Kikuchi-Fujimoto disease (KFD) is a rare cause of rapidly evolving tender cervical lymphadenopathy. It is often initially misdiagnosed and managed as infectious lymphadenitis. Although most cases of KFD are self-limited and improve with antipyretics and analgesics, some are more refractory and may require corticosteroids or hydroxychloroquine therapy.

Case presentation: A 27-year-old White man presented for evaluation of fevers and painful cervical lymphadenopathy. He was found to have KFD on excisional lymph node biopsy. His symptoms proved challenging to manage with corticosteroids but eventually improved with hydroxychloroquine monotherapy.

Conclusions: KFD diagnosis should be considered irrespective of geographic location, ethnicity, or patient sex. Hepatosplenomegaly is a relatively rare manifestation of KFD that can make it especially difficult to distinguish from lymphoproliferative disorder, such as lymphoma. Lymph node biopsy is the preferred diagnostic approach to achieve a timely and definitive diagnosis. Although usually self-limited, KFD has been associated with autoimmune conditions, including systemic lupus erythematosus. Securing the diagnosis of KFD is therefore crucial to ensuring patients are monitored appropriately for the development of associated autoimmune conditions.

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