Clinical analysis of 70 children with histiocytic necrotizing lymphadenitis and significance of lymph node biopsy / 中华实用儿科临床杂志

ABSTRACT

Objective:To observe the distribution ratio of histiocytic necrotizing lymphadenitis(HNL) in the age of children, evaluate glucocorticoids and Hydroxychloroquine therapeutic effects, evaluate the meaning of lymph node excisional biopsy.Methods:The data of 70 cases of patients with the lymph node excisional biopsy in Tianjin Children′s Hospital from December 2010 to August 2019 were retrospectively analyzed.and summarized the treatment experience and prognosis.Results:HNL mostly occurs in children 7-12 years old.The male-female ratio was 1.12∶1.00, but over 13 years old was 0.6∶1.0.Eighteen point one six percent (13 cases) of HNL was relieved after the lymph node excisional biopsy.Thirty-five cases were treated with non-steroidal anti-inflammatory drugs (NSAIDs), and only 10 cases (14.2%) were improved with NSAIDs alone and the rest were improved in combination with glucocorticoids.Four patients with ineffective glucocorticoids therapy were improved in combination with Hydroxychloroquine.Conclusion:HNL in children was more common in school-age children.For children under 13 years old, the incidence among boys is slightly higher than that among girls; for children above 13 years old, the incidence among boys is slightly lower than that among girls.Lymph node biopsy is still the gold standard for diagnosis and is conducive to remission.The course of disease is self-limited, for the cases that NSAIDs is poor, the glucocorticoid treatment should be used.For refractory cases, combined Hydroxychloroquine treatment can be used.