Saratziotis Athanasios, Karakousis Konstantinos, Tzika Kelly, Oikonomou Katerina G, Vlachostergios Panagiotis J
Department of Otorhinolaryngology, General Hospital of Larissa, 41221 Larissa, Greece.
Case Rep Otolaryngol. 2012;2012:267595. doi: 10.1155/2012/267595. Epub 2012 Nov 28.
We report the case of a 19-year-old woman with a history of Hashimoto's thyroiditis who presented with tender right anterior cervical lymphadenopathy and fever. Workup for infectious, autoimmune, and malignant causes was unremarkable. Surgical removal of cervical lymph nodes after detailed magnetic resonance (MR) imaging disclosed necrotizing lymphadenitis, also known as Kikuchi's disease (KD). The patient was treated with a short-term course of steroids, due to the onset of pancytopenia and borderline antiphospholipid antibodies combined with increased anti-thyroglobulin (anti-TG) titers. Despite being a diagnosis of exclusion, KD should be included in the differential of such patients, particularly in cases of previous or concurrent autoimmune diseases such as Hashimoto's thyroiditis, which necessitate a long-term follow-up.
我们报告了一例19岁女性病例,该患者有桥本甲状腺炎病史,出现右侧颈前淋巴结压痛和发热。针对感染性、自身免疫性和恶性病因的检查均无异常。在详细的磁共振成像(MR)检查后,手术切除颈部淋巴结,结果显示为坏死性淋巴结炎,也称为菊池病(KD)。由于全血细胞减少症的出现以及抗磷脂抗体临界值升高并伴有抗甲状腺球蛋白(抗-TG)滴度增加,患者接受了短期的类固醇治疗。尽管KD是一种排除性诊断,但在这类患者的鉴别诊断中应考虑到KD,特别是在既往有或同时患有自身免疫性疾病(如桥本甲状腺炎)的情况下,这类疾病需要长期随访。