Treatment of histiocytic necrotizing lymphadenitis (Kikuchi's disease) with prolonged fever by a single course of methylprednisolone pulse therapy without maintenance therapy: experience with 13 cases.
A 26-year-old man was hospitalized with a 1-month history of fever. Cervical lymph node biopsy showed necrosis in the paracortical area with abundant nuclear debris and proliferation of histiocytes. A diagnosis of histiocytic necrotizing lymphadenitis (HNL) (Kikuchi's disease) was made. He received methylprednisolone pulse therapy (MPT) (0.5 g/day for 3 days) without maintenance therapy and experienced dramatic improvement. We also used MPT for another 12 cases of HNL. All patients became afebrile within 1 day without adverse events. Four patients relapsed after the initial MPT, but only 1 patient relapsed during the following year. Our results suggest that MPT is warranted in HNL patients with prolonged fever.
Department of Internal Medicine, Osaka City General Hospital. kmyoshi@rr.iij4u.or.jp
Katsunobu
K
Yoshioka
Tomoko
T
Miyashita
Tomoyuki
T
Nakamura
Takeshi
T
Inoue
Keiko
K
Yamagami
D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004341:Drug Evaluation; D005260:Female; D005334:Fever / Q000209:etiology*; D020042:Histiocytic Necrotizing Lymphadenitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone