Clinical and diagnostic features of lymphadenopathy in children

Abstract

Objectives: 1.To determine the etiology, clinical and diagnostic features of pediatric lymphadenopathy. 2.To find out the necessity of lymphadenopathy treatment. Methods The retrospective study of 104 outpatient medical records of children (<18 years) who had enlargement of lymph nodes was conducted in the Hospital of Lithuanian University of Health Sciences Kauno Klinikos in the Department of Pediatrics in 2017. Demographics, lymph node involvement sites, serological tests values, radiological examination and treatment options were collected. Data were analyzed with SPSS 23.0. A p value of <0.05 was considered significant. Results The average age of patients was 5.8±4 (3mo -17yrs), 64.4% were male (n=67) and 73.1% (n=76) of children were younger than 7 years. There were more cases (n=94, 91.4%) of bilateral lymphadenopathy. Cervical lymph-nodes were the most affected region (n=82, 78.8%). Almost all children (n=93, 89.4%) had history of frequent viral upper respiratory tract infections (URTI). Others had bacterial infections (n=13, 12%), allergies (n=11, 10.6%), noticed enlarged lymph nodes after chickenpox (n=4, 3.8%) and 2 (1.9%) were scratched by a cat . Ultrasound (US) was performed for 66 (63.5%). An average diameter of a lymph nodes using US was significantly larger (2.2±0.9cm) than evaluated by palpation (1.7±1.1cm), p<0.05. Chest X-ray was performed for 26 (25%) children. Only one X-ray showed specific changes consistent with tuberculosis. Serological tests were performed for 62 (59.6%) children. IgG against Epstein-Barr virus (EBV), Cytomegalovirus (CMV) or Toxoplasma was positive in 94.6%, 61.4% and 7.9% of them. Almost all EBV positive cases (95%) had history of URTI, p<0.05. Most patients (n=96, 92.3%) did not require any specific treatment. Conclusions Lymphadenopathy is more common in younger than 7yrs old male children. The majority had IgG against EBV or CMV. Ultrasound is more accurate met[...].