Treating histiocytic necrotizing lymphadenitis with Chinese herbs: a case report

We present the case of a young woman who suffered from right cervical lymphadenopathy with associated malaise for 8 weeks. The sonography showed multiple, enlarged lymph nodes in the cervical, submaxillary, and subclavicular chains on the right side. The biopsy of a right cervical lymph node disclosed necrosis, histiocytic accumulation, infiltration with lymphocytes and immunoblasts, and cellular debris, demonstrating histiocytic necrotizing lymphadenitis (HNL). Although the patient had received treatment with dexamethasone for 5 weeks and antibiotic drugs for 6 weeks, the lymphadenopathy and the associated malaise had not improved. For fear of the side-effects caused by dexamethasone and the antibiotic drugs, the patient and her parents asked for treatment with Chinese herbs instead of dexamethasone and antibiotics. With the patient's and her parents' consent, the dose of dexamethasone was tapered according to its specifications and Chinese herbs were applied to treat her disease. After 6 weeks of orally administered Chinese herbs both the lymphadenopathy and the associated malaise disappeared. Follow-up by phone 6 months later showed no abnormality. Chinese medicinal herbs, as a natural treatment, can be used as an alternative in treating HNL.