菊池病的诊治(附5例报告并文献回顾)  

Diagnosis and treatment of Kikuchi disease: a report of 5 cases and literature review

作　　者：张继屏[1] 刘越徉 范静平[1] 

机构地区：[1]第二军医大学长征医院耳鼻咽喉科,上海200003

出　　处：《中国现代医学杂志》2015年第17期42-45,共4页China Journal of Modern Medicine

摘　　要：目的探讨菊池病的发病规律、临床表现及诊疗方法,提高对该病的认识及早期诊断率。方法回顾性分析5例菊池病患者的临床资料,并对文献中347例患者的临床资料进行统计分析。结果该病多发于儿童及青年女性,可能与病毒感染或自身免疫相关,主要表现为淋巴结肿大及发热。实验室检查可见白细胞下降,血沉增快,淋巴结活检具有典型的组织病理特征,抗生素治疗无效,激素治疗有效,具有自限性和复发性的特点。结论菊池病临床表现无特异性,确诊的主要依据是淋巴结活检,需避免误诊及漏诊,以糖皮质激素为首选治疗药物,预后良好,但可复发。【Objective】 To investigate the occurrence regularity, clinical characteristics and treatment of Kikuchi disease so as to understand the disease and provide early diagnosis. 【Methods】 The clinical data of5 patients with Kikuchi disease were retrospectively analyzed, and the clinical data of 347 cases in the literatures were statistically analyzed. 【Results】 This observation showed Kikuchi disease chiefly occurred in children and young women, and was related with viral infection or autoimmunity. The clinical manifestations of the disease were lymph node enlargement, sustained fever, low white cell count, fast ESR, etc. And biopsy of the lymph node showed typical manifestations of histiocytic necrotizing lymphadenitis. This disease was resistant to antibiotics, but glucocorticoid had good effect on it. Moreover, it also had the characteristic of self-limitation and recurrence. 【Conclusions】 The clinical manifestations of Kikuchi disease are not specific so it can be easily misdiagnosed. The histopathological examination of affected lymph nodes has contributed greatly to the final diagnosis of the disease. Glucocorticoid therapy is recommended for treatment. Generally speaking,Kikuchi disease has an excellent prognosis but often relapses.

关 键 词：菊池病 组织细胞性坏死性淋巴结炎 临床病理 糖皮质激素 

分 类 号：R551.2[医药卫生—血液循环系统疾病]