CAJ | 학술논문

目的：通过对以不明原因发热就诊的组织细胞坏死性淋巴结炎合并桥本甲状腺炎及自身免疫性溶血性贫血的病例报道并文献复习，探讨诊治方法。方法分析本院发热疾病科收治的1例以不明原因发热就诊的坏死性淋巴结炎合并桥本甲状腺炎及自身免疫性溶血性贫血患者的临床资料并复习相关文献，总结诊治经验。结果患者56岁女性，临床表现为不明原因发热伴关节肌肉痛、咽痛、一过性皮疹、甲状腺肿大、腋窝及腹股沟淋巴结肿大、贫血，根据其临床表现、病理及骨髓穿刺结果确诊为坏死性淋巴结炎合并桥本甲状腺炎及自身免疫性溶血性贫血。结论此例病症临床罕见，对不明原因发热的患者应想到坏死性淋巴结炎及多种自身免疫性疾病伴发的可能，确诊依据病理，治疗主要依靠肾上腺糖皮质激素。
목적：통과대이불명원인발열취진적조직세포배사성림파결염합병교본갑상선염급자신면역성용혈성빈혈적병례보도병문헌복습，탐토진치방법。방법분석본원발열질병과수치적1례이불명원인발열취진적배사성림파결염합병교본갑상선염급자신면역성용혈성빈혈환자적림상자료병복습상관문헌，총결진치경험。결과환자56세녀성，림상표현위불명원인발열반관절기육통、인통、일과성피진、갑상선종대、액와급복고구림파결종대、빈혈，근거기림상표현、병리급골수천자결과학진위배사성림파결염합병교본갑상선염급자신면역성용혈성빈혈。결론차례병증림상한견，대불명원인발열적환자응상도배사성림파결염급다충자신면역성질병반발적가능，학진의거병리，치료주요의고신상선당피질격소。
Objective To study the diagnosis and treatment of histiocytic necrotizing lymphadenitis (HNL) accompanying Hashimoto's thyroiditis (HT) and autoimmune hemolytic anemia (AIHA) by reporting a case of unknown origin fever and reviewing its related literature.Methods The clinical data about a patient with HNL accompanying HT and AIHA admitted to the Department of Fever-Related Diseases in our hospital asa case of unknown origin fever were retrospectively analyzed with its related literature reviewed.Results The patient was a 56-year-old female manifested as unknown origin fever accompanying arthralgia, myalgia, sore-throat, transient skin rash, thyroid enlargement, axillary and inguinal lymph node enlargement, anemia, and was diagnosed as HNL accompanying HT and AIHA according to its clinical manifestations, pathological examination and bone marrow biopsy. Conclusion HNL accompanying HT and AIHA is rarely encountered in clinical practice. HNL and autoimmune diseases should be considered in patients with fever of unknown origin. Its diagnosis depends mainly on its pathological examination and its treatment depends mainly on glucocorticoid.