A case of subacute necrotizing lymphadenitis with recurrent aseptic meningitis associated with persistent high titer of anti-nuclear antibody occurring over a short period of time

• Published in: Rinsho Shinkeigaku Vol. 50; no. 10; pp. 728 - 731
• Main Authors: Yamashita, Taiji, Shibata, Kenichi, Nagano, Sukehisa, Aishima, Shinichi, Yoshimura, Takeo
• Format: Journal Article
• Language: Japanese
• Published: Japan Societas Neurologica Japonica 01.10.2010
• Subjects: Adult; anti-nucleotide antibody; Antibodies, Antinuclear - blood; Female; Histiocytic Necrotizing Lymphadenitis - complications; Histiocytic Necrotizing Lymphadenitis - immunology; Humans; Meningitis, Aseptic - complications; Necrosis; Recurrence; recurrent aseptic meningitis; subacute necrotizing lymphadenitis; systemic lupus erythematosus
• ISSN: 0009-918X; 1882-0654
• DOI: 10.5692/clinicalneurol.50.728

A 35-year-old woman developed recurrent aseptic meningitis three times over a period of 16 months. Each episode followed swelling of her cervical lymph nodes. During the third episode, microscopic findings of biopsied specimens from a cervical lymph node indicated subacute necrotizing lymphadenitis (SNL). While she responded poorly to NSAIDs, steroids rapidly improved her fever, headache and swollen lymph nodes. Since the first episode, anti-nuclear antibody (ANA) and anti-SS-A antibody was positive and the titer of ANA increased with each episode. SNL is a benign and self-limited disease, and the appearance of autoantibodies is usually transient. It is possible that a persistent immune abnormality is related to recurrences of aseptic meningitis with SNL.