[When a Gap Leads to an Answer]. / Wenn eine Lücke zur Lösung führt.

When a Gap Leads to an Answer Abstract. We report the case of a 22-year-old patient who was found somnolent after previously complaining of nausea, abdominal pain, and vomiting. The main findings were high anion gap metabolic acidosis and lactatemia. Causative was the ingestion of ethylene glycol using a car antifreeze agent with suicidal intent.

Relapsing Kikuchi-Fujimoto Disease Requiring Prolonged Steroid Therapy.

We report the case of a 26-year-old woman with an eight-week history of painfully enlarged cervical lymph nodes, recurrent headache, and malaise. Her medical history was unremarkable. The physical examination showed multiple enlarged cervical lymph nodes. Laboratory examination was unremarkable, and magnetic resonance tomographic imaging showed multiple enlarged cervical lymph nodes with aspect of a lymphoma. Lymph node biopsy revealed Kikuchi-Fujimoto disease, histologically characterized by histiocytic necrotizing lymphadenitis. A therapeutic trial with nonsteroidal anti-inflammatory drugs (NSAID) showed no effect, so steroid therapy was started. Due to relapse of symptoms after steroid withdrawal the tapering regimen was prolonged for a total of seven months.