Supplementary Material for: Treating Histiocytic Necrotizing Lymphadenitis with Chinese Herbs: A Case Report

We present the case of a young woman who suffered from right cervical lymphadenopathy with associated malaise for 8 weeks. The sonography showed multiple, enlarged lymph nodes in the cervical, submaxillary, and subclavicular chains on the right side. The biopsy of a right cervical lymph node disclosed necrosis, histiocytic accumulation, infiltration with lymphocytes and immunoblasts, and cellular debris, demonstrating histiocytic necrotizing lymphadenitis (HNL). Although the patient had received treatment with dexamethasone for 5 weeks and antibiotic drugs for 6 weeks, the lymphadenopathy and the associated malaise had not improved. For fear of the side-effects caused by dexamethasone and the antibiotic drugs, the patient and her parents asked for treatment with Chinese herbs instead of dexamethasone and antibiotics. With the patient’s and her parents’ consent, the dose of dexamethasone was tapered according to its specifications and Chinese herbs were applied to treat her disease. After 6 weeks of orally administered Chinese herbs both the lymphadenopathy and the associated malaise disappeared. Follow-up by phone 6 months later showed no abnormality. Chinese medicinal herbs, as a natural treatment, can be used as an alternative in treating HNL.

本研究报告一例右侧颈部淋巴结肿大伴全身不适长达8周的年轻女性病例。超声检查显示，患者右侧颈部、颌下及锁骨下淋巴结链存在多发肿大淋巴结。对右侧颈部淋巴结进行活检，可见组织坏死、组织细胞聚集、淋巴细胞与免疫母细胞浸润及细胞碎屑，确诊为组织细胞性坏死性淋巴结炎（histiocytic necrotizing lymphadenitis, HNL）。尽管患者已接受5周地塞米松治疗与6周抗生素治疗，但淋巴结肿大及伴随的全身不适症状并未得到改善。因担忧地塞米松与抗生素可能引发的不良反应，患者及其家属请求改用中药（Chinese herbs）替代前述药物进行治疗。经患者及家属同意后，按照药品说明书逐步递减地塞米松剂量，并予中药治疗。口服中药治疗6周后，患者的淋巴结肿大及全身不适症状均完全消失。治疗后6个月的电话随访显示无异常表现。作为天然治疗手段，中药可作为组织细胞性坏死性淋巴结炎的替代治疗方案。