Kikuchi's Disease Following Subaccute Thyroiditis

亞急性甲狀腺炎併隨菊地氏病

陳盟方(Meng-Feng Chen) ； 黃學信(Hsueh-Hsin Huang) ； 廖訓斌(Hsun-Bin Liao) ； 方端仁(Tuan-Jen Fang) ； 李達人(Ta-Jen Lee)

《台灣耳鼻喉頭頸外科雜誌》 46卷2期 (2011/04) Pp. 116-120

https://doi.org/10.6286/2011.46.2.116

摘要

菊地氏病是一種良性、自限性疾病，又稱爲組織球壞死性淋巴結炎，通常容易與淋巴瘟、結核性林巴結炎、紅斑性狼瘡或嗜血球症候群箏疾病混淆。菊地氏病可能爲病毒感染所引起的細胞自動凋亡，或是淋巴結壞死。有許多的研究結果認爲自體兔疫及病毒感染就是引起菊地氏病的原因。甲狀腺炎的症狀若有紅腫、疼痛及壓痛感，常是因感染、輻射和創傷所引起的；若無疼痛等急性發炎症狀，則多因自體免疫、藥物控制、或自發性纖維化引發之。有研究報告指出這與腎絲球腎炎、懷孕、輻射及一些自體免疫疾病、結締組織疾病都有相關聯性。本個案爲1名25歲男性病人右頭罹患多處林巴結腫大，依病理報告診斷爲菊地氏病。其初始症狀只有急性甲狀腺疼痛、腫大，初步被認爲是亞急性肉芽腫甲狀腺炎。病毒感染通常被認爲是引起急性上呼吸道感染、亞急性肉芽腫甲狀腺炎、橋本氏甲狀腺炎及菊地氏病的原因，本個素爲上呼吸道感染後併發之菊地氏病和短暫性甲狀腺炎支持上述由病毒感染引發的說法。

關鍵字

菊地氏病 ； 甲狀腺炎 ； 壞死性淋巴結炎

並列摘要

Kikuchi's disease (KD) is a benign, self-limiting histiocytic necrotizing lymphadenitis. This disease is commonly confused with other diseases such as lymphoma, tuberculous lymphadenitis, and systemic lupus erythematosus or hemophagocytic syndrome. The viral infections are the strongly accused factors to cause cell apoptosis, and may be responsible for the necrosis of the lymph nodes. Many studies believe the viral agents and autoimmune are the causative factors of Kikuchi's disease.Thyroiditis is a group of thyroid inflammation disorder that may be painful and tender when caused by infection, radiation and trauma, or painless when caused by autoimmune conditions, medications or an idiopathic fibrotic process. It has been reported to be associated with glomerulonephritis, pregnancy, radiation and some autoimmune, connective tissue diseases.We present the case of a 25-year-old man with multiple right cervical lymphadenopathy, which diagnosed as Kikuchi's disease by pathology. Initially he had diffuse painful thyroid gland swelling only, which diagnosed as subacute granulomatous thyroiditis. Viral infection is usually believed to be the causative agent of acute upper respiratory tract infection, subacute granulomatous thyroiditis, Hashimoto's thyroiditis and Kikuchi’s disease. The coexistence of KD and transient thyroiditis following upper respiratory infection in our patient may support the viral infection to be the etiology.

並列關鍵字

Kikuchi's disease ； thyroiditis ； necrotizing lymphadenitis