亚急性坏死性淋巴结炎33例

Clinical analysis of subacute necrotic lymphadenitis of 33 children

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 ,提高对儿童SNL的认识 ,减少误诊。方法 结合文献资料对SNL患儿 33例临床及实验室相关检查进行回顾分析。结果 本组 33例患儿淋巴结活检确诊SNL ;发病以学龄儿为主 ,2 / 3患儿冬春季节发病 ,男女之比 3.7:1;均有淋巴结大 ,发热 32例 ,白细胞总数减少 2 1例 ;其中 1例发展为系统性红斑狼疮 ,1例复发。结论 对不明原因发热伴淋巴结大者 ,除做相关化验检查外 ,应早期行淋巴结活检以明确诊断。SNL是自限性疾病 ,预后多良好 ,但也有复发。少数发展为系统性红斑狼疮 。

Objective To investigate etiological factors, clinical characteristics and laboratory findings of children's subacute necrotic lymphadenitis (SNL),so as to improve the acknowledge of SNL diagnosis and differential diagnosis and to reduce the misdiagnosis.Methods The clinical manifestations and laboratory findings in the related literature of 33 SNL were retrospectively reviewed. Results Thirty-three cases of SNL were correctly diagnosed by lymph node biopsy. Most of them were school-aged children and 2/3 cases occurred in seasons of winter and spring. The male-to-female ratio was 3.7:1. All patients presented with lymphadenopathy, fever 97 %(32/33), leucocytopenia 60 %(21/33). One case developed systemic lupus erythematosus (SLE), and one had recurrence.Conclusions SNL should be considered when the patient had fever with unknown reasons and lymphadenopathy. In addition to assaying relative laboratory results, making early lymph node biopsy,it is necessary to make a differential diagnosis to role out other related diseases. SNL is self-limited disorder with good prognoses. A few of them might develop into SLE, so long-term follow-up is necessary.