Guéguen Antoine, Sené Thomas, Maillart Elisabeth, Gout Olivier
Neurology Department, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
BMJ Case Rep. 2012 Aug 27;2012:bcr0120125579. doi: 10.1136/bcr.01.2012.5579.
Neurological manifestations have been reported in Kikuchi-Fujimoto disease (KFD). Characteristics of brain lesions are not defined. In addition, no biological indexes are known to help clinicians along the diagnosis process. The authors describe encephalitis associated with KFD. Brain MRI, positron emission tomography (PET) scan and a large biological assessment including interferon α (INF-α) level measurement in cerebrospinal fluid (CSF) were performed. A 39-year-old man with chronic headaches developed diplopia, slow ideation and behavioural disturbances. MRI showed brain lesions particularly in the pontine region and internal temporal lobes with enhancement of the perivacular space and the walls of the lateral ventricle. The IFN-α level was increased in the CSF without viral infection. Cervical and mediastinal adenitis were evident as a hypermetabolic focus on a PET scan, and biopsy confirmed the diagnosis of KFD. The encephalitis spontaneously remitted. The authors characterised brain lesions especially related to KFD in association with increased of IFN-α level in the CSF.
菊池-藤本病(KFD)中已有神经学表现的报道。脑病变的特征尚不明确。此外,尚无已知的生物学指标可协助临床医生进行诊断。作者描述了与KFD相关的脑炎。进行了脑部磁共振成像(MRI)、正电子发射断层扫描(PET)以及包括脑脊液(CSF)中α干扰素(INF-α)水平测定在内的全面生物学评估。一名39岁慢性头痛患者出现复视、思维迟缓及行为障碍。MRI显示脑部病变,尤其在脑桥区域和颞叶内侧,伴有血管周围间隙和侧脑室壁强化。脑脊液中IFN-α水平升高且无病毒感染。PET扫描显示颈部和纵隔淋巴结炎为高代谢灶,活检确诊为KFD。脑炎自发缓解。作者对与KFD相关的脑部病变进行了特征描述,尤其与脑脊液中IFN-α水平升高有关。