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儿童伴脑病的菊池-藤本病:病例报告及文献综述

Kikuchi-Fujimoto Disease With Encephalopathy in Children: Case Reports and Literature Review.

作者信息

Pan Yu-Ting, Cao Li-Ming, Xu Yan, Fan Zhi-Dan, Yu Hai-Guo

机构信息

Department of Rheumatology and Immunology, Children's Hospital of Nanjing Medical University, Nanjing, China.

Department of Infectious Disease, Children's Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Front Pediatr. 2021 Oct 1;9:727411. doi: 10.3389/fped.2021.727411. eCollection 2021.

Abstract

Kikuchi-Fujimoto disease (KFD) is a benign and self-limiting disease characterized by regional lymphadenitis and low-grade fever. Encephalopathy may present in children with KFD. We present three cases of KFD with encephalopathy in children and a literature review. Literature published between 2010 and 2020 was reviewed to understand the clinical features, laboratory findings, and treatments for encephalopathy occurring in children with KFD. The interval between KFD and onset of neurological symptoms was 10 days to 3 months. Laboratory results were normal, except for high protein levels in cerebrospinal fluid findings. Brain magnetic resonance imaging (MRI) findings include hyperintense T2 and FLAIR signal in the supratentorial white matter, deep gray matter, brain stem, cerebellum, temporal lobes, pons, and basal ganglia. Glucocorticoids and immunoglobulin could be effective for treating KFD with encephalopathy. The early clinical manifestations of KFD with encephalopathy in children lack specificity, and the diagnosis is mainly based on CSF analysis and brain MRI findings. Early and timely immunomodulatory therapy is effective and can improve the prognosis of patients with KFD with encephalopathy.

摘要

菊池-藤本病(KFD)是一种以局限性淋巴结炎和低热为特征的良性自限性疾病。脑病可能出现在患有KFD的儿童中。我们报告三例儿童KFD合并脑病的病例并进行文献综述。回顾了2010年至2020年间发表的文献,以了解KFD患儿发生脑病的临床特征、实验室检查结果及治疗方法。KFD与神经症状出现之间的间隔为10天至3个月。除脑脊液检查结果中蛋白质水平升高外,实验室结果均正常。脑磁共振成像(MRI)结果包括幕上白质、深部灰质、脑干、小脑、颞叶、脑桥和基底神经节的T2加权像和液体衰减反转恢复序列(FLAIR)高信号。糖皮质激素和免疫球蛋白对治疗KFD合并脑病可能有效。儿童KFD合并脑病的早期临床表现缺乏特异性,诊断主要基于脑脊液分析和脑MRI结果。早期及时的免疫调节治疗有效,可改善KFD合并脑病患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c75/8519585/38bdf5ac28d5/fped-09-727411-g0001.jpg

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