A Case of Necrotizing Lymphadenitis Suspected as Being Complicated by Bilateral Brachial Plexus Neuritis

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  • 両側腕神経叢炎の併発が疑われた壊死性リンパ節炎例
  • リョウガワ ワン シンケイソウエン ノ ヘイハツ ガ ウタガワレタ エシセイ リンパセツエンレイ

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Abstract

<p>Necrotizing lymphadenitis usually manifests itself with fever, lymphadenopathy and lymph node tenderness, and is more common in young women. At present, the cause of necrotizing lymphadenitis is unknown, but virus infection or vasculitis is believed to be involved. Most patients improve spontaneously and have a good prognosis, but some patients develop complications. To make a definitive diagnosis, lymph node biopsy is sometimes needed.</p><p>We report the case of a 14-year-old girl who presented with high grade fever, cervical lymphadenopathy, bilateral brachial plexus neuritis, and left conjunctival injection. Cervical MRI showed left cervical lymphadenopathy, but brain MRI revealed no abnormalities. Lymph node biopsy was performed because of persistent high grade fever and cervical lymphadenopathy, which revealed the diagnosis of necrotizing lymphadenitis. The patient’s fever and cervical lymphadenopathy improved soon after the start of treatment with prednisolone. The bilateral brachial plexus neuritis improved over a period of 3 months after the start of steroid treatment.</p><p>Necrotizing lymphadenitis and brachial plexus neuritis are diseases with no known cause, but virus infection or vasculitis is believed to be involved. In the field of neurology, doctors sometimes encounter patients with so-called neuralgic amyotrophy (NA), which is characterized by unilateral upper extremity pain, muscle atrophy and paralysis. NA is a type of idiopathic brachial plexus neuritis. Our case meets the clinical criteria for the diagnosis of NA, and the NA in this patient was thought to be a complication of necrotizing lymphadenitis.</p>

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