一名年轻女性表现出与诱发狼疮相关的菊chi-fujimoto病

Galith Kalmi
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摘要

简介:菊池-藤本病(KFD)或组织细胞坏死性淋巴结炎是一种病因不明的良性自限性疾病,主要影响年轻女性。虽然与系统性红斑狼疮(SLE)的关系已被很好地描述,但到目前为止还没有药物性红斑狼疮(DILE)相关的KFD病例报道。病例报告:我们在此报告一名25岁的白人女性,无病史,除口服雌激素-黄体酮避孕(左炔诺孕酮-炔雌醇)外未使用任何药物,表现为颈部淋巴结病,发热和关节痛,无体重减轻,盗汗或皮肤受累。详尽的传染病筛查呈阴性,淋巴结活检显示组织细胞坏死性淋巴结炎提示KFD。自身免疫筛选试验证明抗组蛋白抗体高滴度提示由雌激素-黄体酮药物诱导的DILE。患者接受短期非甾体抗炎治疗,治疗疼痛性淋巴结炎和关节痛。停止口服左炔诺孕酮-炔雌醇避孕药,KFD和DILE完全恢复,抗组蛋白抗体长期消失。结论:我们报告了口服左炔诺孕酮-炔雌醇治疗后KFD相关diile的第一例。尽管左炔诺孕酮-炔雌醇诱导狼疮是众所周知的,但其与KFD的关系从未被报道过,其生理病理机制也尚不清楚。关键词:菊池-藤本病,狼疮,左炔诺孕酮-炔雌醇
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A young woman presenting a kikuchi-fujimoto’s disease associated with induced lupus
Introduction: Kikuchi-Fujimoto’s disease (KFD) or histiocytic necrotizing lymphadenitis is a benign and self-limited disease of unknown etiology mainly affecting young women. Although the association with systemic lupus erythematosus (SLE) is well described, no case of drug-induced lupus erythematosus (DILE) associated KFD has not been reported so far. Case report: We herein report a 25-year old Caucasian woman, with no medical history and no medication except for oral estrogen-progestin contraception (levonorgestrel-ethinylestradiol), who presented with cervical lymphadenopathy, fever and arthralgia without weight loss, night sweats or skin involvement. An exhaustive infectious disease screening was negative and lymph node biopsy revealed histiocytic necrotizing lymphadenitis suggesting KFD. Autoimmune screening tests evidenced high titers of anti-histone antibodies suggesting DILE induced by estrogen-progestin medication. The patient received a short course of non-steroidal anti-inflammatory treatment for painful lymphadenitis and arthralgia. Oral levonorgestrel-ethinylestradiol contraceptive medication was stopped and KFD and DILE completely recovered with a long-term disappearance of anti-histone antibodies. Conclusion: We report the first case of KFD associated-DILE following oral levonorgestrel-ethinylestradiol medication. Even though levonorgestrel-ethinylestradiol induced lupus is well known, the association with KFD has never been reported and the physiopathology remained unknown. Keywords: Kikuchi-Fujimoto disease, Lupus, Levonorgestrel-ethinylestradiol
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