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[Necrotizing lymphadenitis presenting as mesenteric lymphadenopathy].

H Yabe1, I Sinzato, K Hashimoto

  • 1Nishi-Kobe Medical Center.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|September 25, 1999
PubMed
Summary

Necrotizing lymphadenitis (NL) can present with rare intra-abdominal lymph node involvement. Interferon-gamma (IFN-gamma) may play a key role in NL pathogenesis, particularly when associated with hemophagocytic syndrome.

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Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Gastroenterology

Background:

  • Necrotizing lymphadenitis (NL) is a rare condition characterized by lymph node inflammation and necrosis.
  • Intra-abdominal lymphadenopathy is an uncommon presentation of NL, which typically affects cervical lymph nodes.

Observation:

  • A 15-year-old female presented with fever, diarrhea, and abdominal pain, exhibiting enlarged mesenteric lymph nodes.
  • Initial antibiotic treatment was ineffective, with persistent symptoms and laboratory findings suggestive of hemophagocytic syndrome.
  • Histopathological examination revealed necrotizing lymphadenitis with reactive lymphoid hyperplasia of the appendix.

Findings:

  • Elevated levels of IFN-gamma, IL-6, sIL-2R, and ferritin were observed, alongside leukopenia and anemia.

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  • Recurrence of symptoms with cervical lymphadenopathy responded to prednisolone treatment.
  • The case highlights the unusual intra-abdominal presentation of NL and its association with hemophagocytic features.

    • Implications:

    • This case suggests that IFN-gamma may be implicated in the pathogenesis of NL, especially in cases with hemophagocytic syndrome.
    • The findings broaden the understanding of NL's clinical spectrum and diagnostic considerations.
    • Further research into the role of specific cytokines in NL is warranted.