Primary Epstein-Barr Virus Infection Associated with Kikuchi's Disease and Hemophagocytic Lymphohistiocytosis: A Case Report and Review of the Literature

被引:22
|
作者
Lee, Hao-Yuan [1 ,2 ]
Huang, Yhu-Chering [1 ,2 ]
Lin, Tzou-Yien [1 ,2 ]
Huang, Jing-Long [1 ,2 ]
Yang, Chao-Ping [1 ,2 ]
Hsueh, Tsun [3 ]
Wu, Chang-Teng [1 ]
Hsia, Shao-Hsuan [1 ,2 ]
机构
[1] Chang Gung Mem Hosp, Dept Pediat, Tao Yuan, Taiwan
[2] Chang Gung Univ, Coll Med, Tao Yuan, Taiwan
[3] Chang Gung Mem Hosp, Dept Clin Pathol, Tao Yuan, Taiwan
关键词
Epstein-Barr virus; hemophagocytic lymphohistiocytosis; Kikuchi's disease; HISTIOCYTIC NECROTIZING LYMPHADENITIS; FUJIMOTO-DISEASE; CHILDREN;
D O I
10.1016/S1684-1182(10)60040-0
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
An association between hemophagocytic lymphohistiocytosis (HLH) and Kikuchi's disease is rarely seen in children. Here, we present the case of a male adolescent (age 16 years and 3 months) who suffered from spiking fever for more than 1 week, and multiple nodules over the neck and bilateral axilla for 2 months. A skin rash also developed over all four limbs, abdomen and face. Laboratory data and skin biopsy gave results compatible with a diagnosis of Kikuchi's disease. Hemophagocytosis in the bone marrow, hypertriglyceridemia, elevated ferritin, and splenomegaly were also found, fulfilling the criteria for HLH. A recent primary Epstein-Barr virus infection was also diagnosed by serology. The patient ran a relatively benign course. Intravenous immunoglobulins, steroids or etoposide-containing regimens were not used, and his recovery was uneventful. A review of the literature showed that up to February 2009, 11 additional cases of Kikuchi's disease presenting simultaneously with, or mimicking, HLH had been reported. Complete resolution within several weeks, with no recurrence, was seen in all but one patient (a pregnant woman).
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页码:253 / 257
页数:5
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