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mRNA新冠疫苗接种后发生的菊池-藤本病或组织细胞坏死性淋巴结炎:1例罕见病例

Kikuchi-Fujimoto's Disease or Histiocytic Necrotizing Lymphadenitis Following mRNA COVID-19 Vaccination: A Rare Case.

作者信息

Daghri Sanae, Belmoufid Nadia, Rami Amal, Al Bouzidi Abderahmane, Bouanani Nouama

机构信息

Department of Hematology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

Department of Radiology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

出版信息

Cureus. 2022 Apr 15;14(4):e24155. doi: 10.7759/cureus.24155. eCollection 2022 Apr.

Abstract

Kikuchi-Fujimoto disease (KFD), also known as necrotizing histiocytic lymphadenopathy, is a rare and benign lymph node disorder that mainly occurs in young women. It is clinically characterized by fever with tender and painful cervical lymphadenopathy mostly; however, all areas of lymph nodes can be involved. This disorder is often mistaken for malignant lymphoma or infection. The precise pathophysiology of KFD remains unknown, but it is theorized that it may be post-viral or associated with an autoimmune disease. The diagnosis is based on the histological analysis of the excised involved lymph node. The treatment is mainly supportive with favorable outcomes within a few weeks or months. In this case, we present a 24-year-old woman without a past medical history, who consulted for painful bilateral cervical lymphadenopathy associated with fever that has been evolving for one month following the coronavirus disease 2019 (COVID-19) vaccination. The initial diagnostic workup was performed and the diagnosis of KFD was confirmed based on the histopathological findings of the excised lymphadenopathy. Therapeutic management was based on oral corticosteroid treatment with clinical and radiological improvement after a few days without recurrence during follow-up. This article aims to report a rare case of KFD in a patient after receiving the messenger ribonucleic acid (mRNA)-based COVID-19 vaccine. Therefore, this case highlights the possible association between COVID-19 vaccination and KFD and this should be considered in the differential diagnosis.

摘要

菊池-藤本病(KFD),又称坏死性组织细胞性淋巴结病,是一种罕见的良性淋巴结疾病,主要发生于年轻女性。其临床特征主要为发热伴颈部淋巴结压痛;然而,所有淋巴结区域均可受累。这种疾病常被误诊为恶性淋巴瘤或感染。KFD的确切病理生理学尚不清楚,但据推测可能是病毒感染后发生的,或与自身免疫性疾病有关。诊断基于对切除的受累淋巴结进行组织学分析。治疗主要是支持性的,几周或几个月内预后良好。在此病例中,我们报告一名既往无病史的24岁女性,因接种2019冠状病毒病(COVID-19)疫苗后出现双侧颈部疼痛性淋巴结肿大伴发热前来就诊,该症状已持续1个月。进行了初步诊断检查,并根据切除的淋巴结病变的组织病理学结果确诊为KFD。治疗管理基于口服糖皮质激素治疗,数天后临床和影像学表现改善,随访期间无复发。本文旨在报告1例接种基于信使核糖核酸(mRNA)的COVID-19疫苗后发生KFD的罕见病例。因此,该病例凸显了COVID-19疫苗接种与KFD之间可能存在的关联,在鉴别诊断时应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd8d/9110038/a8e30740f968/cureus-0014-00000024155-i01.jpg

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