All issues > Volume 41(7); 1998

Case Report

J Korean Pediatr Soc. 1998;41(7):994-1000. Published online July 15, 1998.

The Lymphocyte Subset Change in a Case of Subacute Necrotizing Lymphadenitis

Ji Hyang JH Doh¹, Sung Taek ST Kim¹, Kyeong Shin KS Lee², So Young SY Jeong³

¹Department of Pediatrics, Dong-Eui Medical Center, Pusan, Korea
²Department of Pathology, Dong-Eui Medical Center, Pusan, Korea
³Department of Clinical Pathology, Dong-Eui Medical Center, Pusan, Korea

Correspondence Ji Hyang JH Doh ,Email: 1

Abstract

The subacute necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease, is a benign, self-limited disorder of unknown cause. This rare disease is characterized by fever, lymphadenopathy, leukopenia, and elevated sedimentation rate. This disease preferentially affects young women. The diagnosis of this disease is confirmed by involved lymphnodes biopsy. Evidence for autoimmune dysfunction has been reported, but is usually lacking. According to the review of the literatures, a total of 192 cases of subacute necrotizing lymphadenitis were reported in Korea since 1983 mostly in literatures of pathology or internal medicine and only 7 cases in pediatrics. There was female predominance in a 141:51 ratio. However, among 25 cases of under 20 years of age, there was male predominance in a 16:9 ratio. The patients of under and over 20 years of age were 29 and 82, respectively among the age-known 111 cases of 192 reported. We experienced a 13-year-old boy, who had right cervical lymphadenitis with persisting high temperature and pain on lymph nodes for more than 10 days. An excisional cervical lymph node biopsy was performed and pathologic diagnosis was compatible with subacute necrotizing lymphadenitis. Most antibiotics were not effective, but fever subsided with one day of oral prednisolone therapy. Various laboratory studies for prolonged fever were negative except leukopenia and increased sedimentation rates. The CD4/CD8 ratios in acute and recovery stages were 1.1 and 1.5 respectively, showing mild decrease of CD4/CD8 ratio in the acute stage. Decreased T cell proportions in the acute stage were also noted.

Keywords :Lymphocyte Subset, Subacute necrotizing lymphadenitis