[Subacute necrotizing lymphadenitis associated with mononeuritis multiplex. A case report].

A 20-year-old man noticed lymph node swelling in his neck in May 1997. He was admitted to our hospital on July 30 because of numbness and weakness in the right hand and bilateral lower extremities. Neurological examinations revealed that the patient had right ulnar and bilateral deep peroneal nerve palsies. Nerve conduction study showed severe axonopathy in these nerves. The sural nerve biopsy demonstrated axonal degeneration and thickening of the small arterial wall. There was no significant increase of virus titer in the serum, such as EB virus, nor human herpesvirus 6. CSF examination was normal. During the course of this disorder, he acutely developed severe pain in his right testis. Pathological finding of the testis showed necrosis with vasculitis in the small arteries. Treatment with corticosteroid was effective. Usually subacute necrotizing lymphadenitis has been thought to be a benign disease. Only a few neurological complications, such as aseptic meningitis and cerebellar ataxia have been reported. Mononeuritis multiplex associated with subacute necrotizing lymphadenitis has not been reported. We speculated that the present case initially had some viral infection, and its reaction of the host produced subacute necrotizing lymphadenitis and mononeuritis multiplex.