小儿亚急性坏死性淋巴结炎临床特征分析

Analysis of the clinical characteristic of subacute necrotizing lymphadenitis in infants

目的探讨儿童亚急性坏死性淋巴结炎(SNL)的病因及临床特征和治疗方法,提高对儿童SNL的认识,减少误诊误治。方法对SNL患儿38例临床及实验室相关检查进行回顾分析。结果本组38例患儿淋巴结活检确诊SNL;发病以学龄儿为主,患儿发病无季节性,男女之比1.1:1,38例淋巴结大及发热,30例白细胞总数减少;其中1例发展为SLE,2例复发。结论对不明原因长期发热伴淋巴结大者,应早期行淋巴结活检以明确诊断;手术取受累最大淋巴结,可作为一种诊断性治疗;SNL是自限性疾病,预后多良好,但少数也有复发或发展SLE,应长期规律随访。

Aim To investigate etiological factors,clinical characteristics and laboratory findings of children with subaeute necrotic lymphadenitis （SNL）. Methods The clinical manifestations and laboratory findings of 38 SNL eases were retrospectively reviewed. Results 38 SNL eases were diagnosed by lymph node biopsy. Most of them were school - aged infantsand the prevalent rate was without seasonal variations.The male-to-female ratio was1.1：1. All patients presented with lymphadenopathy and fever,30 of them had leueocytopenia （78.9%） . One case developed systemic lupus eryth ematosus（SLE） and recurrence occurred to two cases. Conclusions SNL should be considered when the patient had fever with unknown reasons and lymphadenopathy. In addition early lymph node biopsy is necessary to make a differential diagnosis to rule out other related diseases. A biopsy of affected lymph node can be considered as one way of diagnostic therapy . SNL is self - limited disorder with good prognoses. A few of them might develop into SL E , thus long term follow - up is necessary.