摘要
目的探讨组织细胞坏死性淋巴结炎(HNL)的临床特征,分析相关实验室检查结果。方法我院呼吸科2008年收治1例HNL患者,结合文献报道477例共478例进行回顾分析。结果478例HNL可见于各年龄段,男女比例为0.88:1。临床表现颈部淋巴结肿大占96.4%(325/337),发热占93.8%(436/465),可伴有肝肿大20.7%(61/294),脾肿大22.0%(68/309)和皮疹20.5%(87/425)。实验室检查:72.1%(305/423)一过性白细胞计数下降,27.6%(74/268)贫血,87.5%(309/353)血沉增快。7.6%(12/158)抗核抗体阳性,4.6%(3/65)抗DsDNA抗体阳性。17.0%(15/88)EB病毒IgM抗体阳性,50.0%(51/102)EB病毒IgG抗体阳性,4.5%(2/44)支原体抗体阳性,12.5%(5/40)巨细胞病毒IgM抗体阳性,18.8%(3/16)巨细胞病毒IgC.抗体阳性,10.6%(13/123)柯萨奇病毒IgM抗体阳性。7.8%(19/244)复发。结论HNL可能为多种病原体感染导致的自限性自身免疫性疾病,以长期发热、颈部淋巴结肿大为主要特征,可引起多脏器损害,可复发,确诊需淋巴结活检病理检查,抗生素治疗无效,激素及非甾体抗炎药治疗有效。
Objective To investigate the clinical characteristics and related laboratory findings of histiocytic necrotizing lymphadenitis(HNL). Methods Retrospective analyzed 1 patient from the department and 477 patients reported in literatures. Results All the age groups can be in onset of HNL. The ratio of male to female was 0.88: 1. Clinical characteristics include cervical lymphadencctasis 96.4% (325/ 337 ), fever 93.8 % (436/465) , hepatomegaly 20.7% (61/294 ), splenomegaly 22.0% ( 68/309 ) and skin rash 20.5% (87/425). Laboratory tests include a transient decrease of WBC 72.1% (305/423), hemophthisis 27.6% ( 74/268 ) ,increased ESR 87.5% ( 309/353 ), positive rate of ANA 7.6% ( 12/158 ), antids-DNA antibody 4.6% (3/65) ,EB virus IgM 12.5% (5/40) ,EB virus IgG 50.0% (51/102) ,mycoplasma antibody 4.5% (2/44) ,CMV-IgM 18.8% (3/16) ,CMV-IgG 18.8% (3/16) ,COX virus-IgM 10.6% (13/123). Recurrence rate 7.8% (19/244). Conclusion HNL might be an autoimmune disease with self-limitation caused by multi-microorganism which has a main characteristics of fever and cervical lymphadencctasis and lead to multiple organ damage. Lymph node biopsy is the only way to diagnose HNL. HNL is not responsive to antibiotic therapy but to glucocorticoid and non-steroidal anti-inflammatory drugs.
出处
《临床内科杂志》
CAS
2010年第1期56-59,共4页
Journal of Clinical Internal Medicine