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Abstract：
OBJECTIVE: To characterize the clinical features and to identify the predictors of recurrence of histiocytic necrotizing lymphadenitis (HNL) in Chinese children.
METHODS: This study retrospectively analyzed the clinical characteristics, laboratory and pathological findings, and recurrence status of children diagnosed with HNL at a single center in China from January 2018 to May 2023. Logistic regression analysis was employed to identify predictors of HNL recurrence.
RESULTS: 181 Chinese children with histopathologically confirmed HNL were enrolled (121 males and 60 females). The mean age was 9.3 ± 2.9 years. The most prominent clinical features were fever (98.9%) and cervical lymphadenopathy (98.3%). Aseptic meningitis was the most frequent complication (38.5%), while hemophagocytic lymphohistiocytosis and autoimmune disease were rare (1.7% and 1.2%, respectively). Recurrence occurred in 12.7% of patients. Erythrocyte sedimentation rate (> 30 mm/h) was the significant predictors of HNL recurrence, with odds ratios of 6.107, respectively.
CONCLUSIONS: Our study demonstrates that fever and cervical lymphadenopathy are the most frequent clinical manifestations of HNL in Chinese children, which often coexist with aseptic meningitis. HNL patients with risk factors require follow-up for recurrence.
METHODS: This study retrospectively analyzed the clinical characteristics, laboratory and pathological findings, and recurrence status of children diagnosed with HNL at a single center in China from January 2018 to May 2023. Logistic regression analysis was employed to identify predictors of HNL recurrence.
RESULTS: 181 Chinese children with histopathologically confirmed HNL were enrolled (121 males and 60 females). The mean age was 9.3 ± 2.9 years. The most prominent clinical features were fever (98.9%) and cervical lymphadenopathy (98.3%). Aseptic meningitis was the most frequent complication (38.5%), while hemophagocytic lymphohistiocytosis and autoimmune disease were rare (1.7% and 1.2%, respectively). Recurrence occurred in 12.7% of patients. Erythrocyte sedimentation rate (> 30 mm/h) was the significant predictors of HNL recurrence, with odds ratios of 6.107, respectively.
CONCLUSIONS: Our study demonstrates that fever and cervical lymphadenopathy are the most frequent clinical manifestations of HNL in Chinese children, which often coexist with aseptic meningitis. HNL patients with risk factors require follow-up for recurrence.
摘要：
目的：探讨中国儿童组织细胞坏死性淋巴结炎(HNL)的临床特点及复发预测因素。
方法：本研究回顾性分析临床特点，实验室和病理结果，以及2018年1月至2023年5月在中国单个中心诊断为HNL的儿童的复发状况。采用Logistic回归分析确定HNL复发的预测因子。
结果：181名组织病理学证实为HNL的中国儿童纳入研究（男性121名，女性60名）。平均年龄为9.3±2.9岁。最突出的临床特征是发热（98.9%）和颈部淋巴结肿大（98.3%）。无菌性脑膜炎是最常见的并发症（38.5%），而噬血细胞性淋巴组织细胞增多症和自身免疫性疾病很少见（1.7％和1.2％，分别)。12.7%的患者复发。红细胞沉降率（>30mm/h）是HNL复发的重要预测因子，比值比分别为6.107。
结论：我们的研究表明，发烧和颈淋巴结肿大是中国儿童HNL最常见的临床表现，通常与无菌性脑膜炎共存。有危险因素的HNL患者需要随访才能复发。
方法：本研究回顾性分析临床特点，实验室和病理结果，以及2018年1月至2023年5月在中国单个中心诊断为HNL的儿童的复发状况。采用Logistic回归分析确定HNL复发的预测因子。
结果：181名组织病理学证实为HNL的中国儿童纳入研究（男性121名，女性60名）。平均年龄为9.3±2.9岁。最突出的临床特征是发热（98.9%）和颈部淋巴结肿大（98.3%）。无菌性脑膜炎是最常见的并发症（38.5%），而噬血细胞性淋巴组织细胞增多症和自身免疫性疾病很少见（1.7％和1.2％，分别)。12.7%的患者复发。红细胞沉降率（>30mm/h）是HNL复发的重要预测因子，比值比分别为6.107。
结论：我们的研究表明，发烧和颈淋巴结肿大是中国儿童HNL最常见的临床表现，通常与无菌性脑膜炎共存。有危险因素的HNL患者需要随访才能复发。
