LYMPHADENOPATHY management
LYMPHADENOPATHY
Remember-
Generally, lymph nodes less than 3 mm are considered normal
Abnormal lymph nodes are as below
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Epitrochlear lymph nodes > 5mm
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Cervical lymph nodes >10 mm
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Inguinal lymph nodes > 15 mm
TYPES
- a) Generalised lymphadenopathy-
When 2 or more groups of lymph node regions are enlarged
Liver and spleen may also be enlarged.
- b) Local lymphadenopathy
CAUSES
a) Systemic infections
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Bacterial infections
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Viral infections- EBV/ EMV/ Hepatitis/
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Tuberculosis/ syphilis/ Toxoplasma
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Brucella/ typhoid/ malaria
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Chronic granulomatous disease/ HIV
b) Immune-mediated conditions
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SLE/ Rheumatoid arthritis
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Kawasaki disease/ Hyper IgD syndrome
c) Storage diseases-
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Gaucher/ Niemann Pick disease
d) Malignancy-
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Leukemia/ Lymphoma
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Neuroblastoma/ Histiocytosis
e) Metabolic causes-
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Hyperthyroidism/ adrenal insufficiency
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Sarcoidosis/ Histiocytosis
CERVICAL LYMPHADENOPATHY CAUSES-
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Viral Upper respiratory tract infection( EBV/CMV virus)
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Bacterial infection (Staphylococcal/ Streptococcal)
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Atypical mycobacterial adenitis
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Toxoplasmosis
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Kawasaki disease
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Hyper IgD or IgE syndrome
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Histiocytosis
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Sarcoidosis
HISTORY to consider-
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History of fever- Suggesting systemic infections
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History of rash- Suggesting EBV/ CMV/ Chronic granulomatous disease/ syphilis
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History of travel- look for Malaria/ Histoplasmosis
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History of animal exposure- suggesting Brucellosis/ cat scratch disease/ tularemia
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History of blood transfusion – Hepatitis A/B/C, CMV virus/ HIV
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History of Malar rash, alopecia/ cardiac disease/ Raynaud’s phenomenon – Systemic lupus erythematosus
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History of fever/ rash/ joint disease- Juvenile rheumatoid arthritis
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History of fever/ rash/ conjunctivitis/ skin peeling- Kawasaki disease
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History of hepatosplenomegaly/ growth failure/ delay in development- Storage diseases
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History of weight loss/ night sweats/ bone pain/ bleeds- Malignancy