Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, Japan.
Department of General Medicine, National Hospital Organization Kyoto Medical Center, Japan.
Intern Med. 2022 Aug 15;61(16):2527-2532. doi: 10.2169/internalmedicine.9384-22. Epub 2022 Jun 14.
We herein report a case of multisystem inflammatory syndrome in adults (MIS-A) complicated with Kikuchi-Fujimoto disease (KFD). A previously healthy 41-year-old man presented with painful swelling of the cervical lymph nodes, fever, diarrhea, conjunctivitis, edema, and hypotension one month after the onset of asymptomatic coronavirus disease 2019. Laboratory investigations revealed an elevation of CRP, and echocardiography indicated diastolic dysfunction. We diagnosed the patient to have MIS-A. Histopathology of the lymph nodes showed necrotizing lymphadenitis. After the initiation of hydrocortisone and diuretics, his symptoms resolved immediately. This case suggested that post-viral immune dysregulation in MIS-A could play a role in the etiology of KFD.
我们在此报告一例成人多系统炎症综合征（MIS-A）合并菊池-藤本病（KFD）。一名 41 岁既往健康的男性在无症状 2019 冠状病毒病发病一个月后出现颈淋巴结疼痛性肿胀、发热、腹泻、结膜炎、水肿和低血压。实验室检查发现 CRP 升高，超声心动图提示舒张功能障碍。我们诊断该患者为 MIS-A。淋巴结的组织病理学显示坏死性淋巴结炎。皮质激素和利尿剂治疗开始后，他的症状立即得到缓解。本病例提示 MIS-A 中的病毒后免疫失调可能在 KFD 的发病机制中起作用。
