Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of subacute necrotizing lymphadenitis with recurrent aseptic meningitis 11 years after the first episode

Kaori Itokawa, M.D.1), Miki Fukui, M.D.1), Yoshihiko Nakazato, M.D.1), Toshimasa Yamamoto, M.D.1), Naotoshi Tamura, M.D.1), Seiya Sannohe, M.D.2) and Kunio Shimazu, M.D.1)

1)Department of Neurology, Saitama Medical University
2)Department of Pathology, Saitama International Medical Center

We report a 29-year-old man with subacute necrotizing lymphadenitis (SNL) associated with recurrent aseptic meningitis following an 11-year remission period. In both episodes, headache and fever were followed by lymphadenopathy, with increased serum IgE level. Although pleocytosis in cerebrospinal fluid was confirmed at admission in the first episode, it appeared at one week after admission in the second episode. Administration of glucocorticoid was effective for treating meningitis. The present case suggests a pathomechanism for SNL that involves both an immunological background and an acute viral infection as triggers of exacerbation of aseptic meningitis.
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(CLINICA NEUROL, 48: 275|277, 2008)
key words: subacute necrotizing lymphadenitis, recurrence, aseptic meningitis, steroid, IgE

(Received: 23-Oct-07)