无菌性脑膜炎显示孤立的菊池-藤本病

S. Bouomrani, Nesrine Regaïeg
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引用次数: 1

摘要

简介:Kikuchi-Fujimoto病(KFD)或组织细胞坏死性淋巴结炎是一种罕见的疾病,由于其高度多形性和有时不寻常的表现,对临床医生来说可能是一个真正的诊断挑战。我们报告一个原始观察的KFD与无菌性脑膜炎的首次表现。病例报告:30岁女性,无病理病史,因脑膜综合征伴颈淋巴肿大经急诊科住院。腰椎穿刺显示无菌性脑膜炎:脑脊液清晰,血压正常,白细胞28/mm3(90%淋巴细胞),红细胞2/mm3, rrachia蛋白0.58 g/l,葡萄糖4 mmol/l,静脉血糖8 mmol/l,直接检查和培养阴性。脑髓核磁共振、脑血管核磁共振未见异常。进一步的感染和免疫检查均为阴性。颈部淋巴结活检显示组织学和免疫组化提示KFD。全身性皮质类固醇治疗后,病情发展良好,无复发。结论:kfd相关的无菌性脑膜炎仍然是罕见的,并且最初的形式是特殊的,往往难以诊断。更好地了解这种联系可以避免不必要的调查,复发,并改善疾病的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Aseptic meningitis revealing isolated Kikuchi-Fujimoto disease
Introduction: Kikuchi-Fujimoto’s disease (KFD) or histiocytic necrotizing lymphadenitis is a rare entity that may represent a real diagnostic challenge for the clinician because of its highly polymorphous and sometimes unusual presentations. We report an original observation of KFD with aseptic meningitis as inaugural manifestation. Case report: 30-year-old woman, without pathological medical history, was hospitalized via the emergency department for exploration of a meningeal syndrome with cervical lymphadenopathies. The lumbar puncture showed aseptic meningitis: clear, normotensive cerebrospinal fluid with leukocytes at 28/mm3 (90% lymphocytes), red blood cells at 2/mm3, proteinrrhachia at 0.58 g/l, glucorrachia at 4 mmol/l for venous glycemia at 8 mmol/l, and negative direct examination and culture. Cerebromedullary MRI and cerebral angio-MR were without abnormalities. Further infectious and immunological investigations were negative. Cervical lymph node biopsy showed histological and Immunohistochemical aspects suggesting KFD. Treated with systemic corticosteroids, the evolution was favorable with no recurrence. Conclusion: KFD-associated aseptic meningitis remains rare, and the inaugural forms are exceptional and often difficult to diagnose. A better knowledge of this association avoids unnecessary investigations, recurrence, and improves the prognosis of the disease.
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