A Case of Kikuchi-Fujimoto Disease associated with Aseptic Meningitis and Cerebellitis
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Histiocytic necrotizing lymphadenitis (HNL) or Kikuchi-Fujimoto disease are a rare, self-limited lymphadenopathy accompanied by fever and various extranodal manifestations. Although neurological complications occasionally occur in HNL, cerebellar symptoms are very rare. Here we report a 15-year-old male patient who was admitted to Kyung Hee University College of Medicine complaining of headache, fever, and axillary lymph node enlargement. The patient did not respond to antibiotics. We performed excisional biopsies on the involved lymph nodes. We diagnosed HNL and the patient initially seemed to recover. However, the headache and fever then worsened and he developed diplopia, ataxia, and action tremor on the 5th hospital day. An action tremor was evident on conducting the finger to nose test, he failed the Romberg test and tandem gait. Cerebrospinal fluid pleocytosis and an elevated protein level were noted. Viral and tuberculosis markers in serum and cerebrospinal fluid were all negative. We diagnosed him as having HNL accompanied by aseptic meningitis and cerebellitis, which were suspected to be associated with an immune- mediated mechanism.
Abstract
Histiocytic necrotizing lymphadenitis (HNL) or Kikuchi-Fujimoto disease are a rare, self-limited lymphadenopathy accompanied by fever and various extranodal manifestations. Although neurological complications occasionally occur in HNL, cerebellar symptoms are very rare. Here we report a 15-year-old male patient who was admitted to Kyung Hee University College of Medicine complaining of headache, fever, and axillary lymph node enlargement. The patient did not respond to antibiotics. We performed excisional biopsies on the involved lymph nodes. We diagnosed HNL and the patient initially seemed to recover. However, the headache and fever then worsened and he developed diplopia, ataxia, and action tremor on the 5th hospital day. An action tremor was evident on conducting the finger to nose test, he failed the Romberg test and tandem gait. Cerebrospinal fluid pleocytosis and an elevated protein level were noted. Viral and tuberculosis markers in serum and cerebrospinal fluid were all negative. We diagnosed him as having HNL accompanied by aseptic meningitis and cerebellitis, which were suspected to be associated with an immune- mediated mechanism.
참고문헌 (15)
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