An 11-year-old boy was admitted to our hospital because of intermittent high fever, leukopenia, thrombocytopenia, and lymph node enlargements in right neck in May 1987. Lymph node biopsy revealed wide areas of necrosis with nuclear debris. A diagnosis of subacute necrotizing lymphadenitis (SNL) was made. Bone marrow aspiration showed markedly hypocellular marrow with proliferation of mature histiocytes with hemophagocytosis. Serum ferritin was raised to 19,310 ng/ml and SGOT, SGPT, and serum triglycelide were elevated. These findings were compatible with virus-associatted hemophagocytic syndrome (VAHS). He completely recovered from these symptoms 6 weeks later without treatment. Both SNL and VAHS are considered to be associated with infection, and immunological dysregulation of the host. The present case suggests these two disorders may be closely related.
