Parvovirus B19‐associated haemophagocytic syndrome with lymphadenopathy resembling histiocytic necrotizing lymphadenitis (Kikuchi's disease)

Abstract

A 15‐year‐old girl developed a haemophagocytic syndrome caused by human parvovirus B19 (PVB19). The cervical lymph node histology, resembling that of histiocytic necrotizing lymphadenitis (HNL, Kikuchi’s disease), included several transformed lymphocytes, numerous histiocytes, and massive necrosis. We detected PVB19‐positive cells in the lymph node by immunohistochemistry. Possible autoimmune mechanisms in HNL‐like diseases triggered by PVB19 are discussed.

Haemophagocytic syndrome and histiocytic necrotising lymphadenitis (Kikuchi's disease)

“…9 There was no evidence of recent parvovirus B19 infection in our patient. Extensive microbiological investigations showed evidence of recent infection only with RSV and non-haemolytic and haemolytic streptococci.…”

Clinical and Laboratory Manifestations of Kikuchi's Disease in Children and Differences Between Patients With and Without Prolonged Fever

“…6,9 Viruses such as EpsteinBarr virus, cytomegalovirus, type I human T cell lymphotrophic virus, human herpesvirus 6 or parvovirus B-19 have been suspected based on serologic studies or polymerase chain reaction evidence of infection. [13][14][15][16][17] However, none of these viruses has been definitely linked to the disease. It is possibly a hyperimmune reaction to various etiologic agents including viruses and chemicals.…”

Parvovirus B19 infection associated with unilateral cervical lymphadenopathy, apoptotic sinus histiocytosis, and prolonged fatigue

“…Thus, it differed from the pattern of necrotising lymphadenitis (Kikuchi's disease) described so far. 9 Apoptosis is related to necrosis and may constitute a precursor or an intermediate stage in which the pathogen is unable to cause necrosis. If present, necrosis should lead to alterations of the normal lymph node architecture, such as fibrosis or sclerosis, which were not detectable in our case.…”