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아급성 괴사성 임파선염의 임상양상과 비전형적인 증례 소개

Other Titles
 Clinical Characteristics and Atypical Cases of Subacute Necrotizing Lymphadenitis 
Authors
 이꽃실  ;  장경희  ;  홍성관  ;  최준용  ;  김영근  ;  김명수  ;  허애정  ;  염준섭  ;  송영구  ;  김동수  ;  김준명 
Citation
 INFECTION AND CHEMOTHERAPY (감염과 화학요법), Vol.34(4) : 220-229, 2002 
Journal Title
 INFECTION AND CHEMOTHERAPY (감염과 화학요법) 
ISSN
 1598-8112 
Issue Date
2002
Keywords
Subacute necrotizing lymphadenitis (SNL) ; Lymphadenopathy ; Clinical Characteristics ; Disseminated intravascular coagulopathy (DIC)
Abstract
Background:Subacute necrotizing lymphadenitis (SNL) or Kikuchi-Fujimoto disease, first described in 1972, is a benign process of lymphatic system that consists of lymphadenopathy which may be accopanied by fever, rash and some hematologic alterations. It affects usually young people, mostly women. Even though this disease is self-limited, many cases are misidentified as malignant lymphoma. The purpose of this study is to report the clinical characteristics, many laboratory tests and pathologic finding and to elaborate the criteria that are useful in distinguishing from fever cause. We are going to present some rare cases and fatal cases. Methods:Authors evaluated 116 patients, who were diagnosed as Subacute necrotizing lymphadenitis on excisional biopsy with retrospective chart review at Yonsei Medical Center from January 1993 to May 2000. Results:The mean age was 26.4±10.9 years (range:5~63 years) and the male to female ratio was 1:2.28. The most common symptoms were cervical lymphadenopathy (89.7%) and fever (57.8%), and the duration of symptom was generally less than 8 weeks. Leukopenia (74.4%), relative lymphocytosis (33.3%) and DIC (7 cases) were hematologic abnormalities. Recently, we experienced patients showing atypical clinical findings which were pancytopenia, DIC (disseminated intravascular coagulopathy), hypotension or debilitating symptoms. Steroid pulse or high dose steroid and immunosuppressant therapy were performed in atypical cases. Sj?gren some cases were rarely associated with systemic diseases such as systemic lupus erythematosus (4 cases), Sj?gren disease (2 cases), rheumatoid arthritis (3 cases), aseptic meningitis (2 cases) or adult Still's disease (1 case). Thirteen cases (10.9%) were recurrent, and two cases died. Conclusion:Subacute necrotizing lymphadenitis should be considered in the differential diagnosis of fever cause in the patients which had localized cervical adenopathy, unresponsive to antibiotic therapy, especially in young women. We report atypical or fatal cases and need clinical attention to this kind of possibility.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/144010
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