Causes of lymphadenopathy in children

Causes of lymphadenopathy in children

Lymph nodes belong to the organs of immunity.

The role of lymph nodes:

  • Barrier. Lymph nodes (LU) are the “first line of defense” in the penetration path various alien agents in the child's body. Regular response on this “acquaintance” is an increase in lymph nodes.

  • Filtration. Various substances, microbial cells, particles settle in the UL. own body tissues.

Parents very often enlarged lymph nodes are called"Glands".

By itself, the lymph node is an oval formation of small size (several millimeters in diameter). Outside it is covered with a special capsule. from connective tissue, and inside divided by partitions into separate sections. These elements of the immune system are located in small groups throughout the body in places merger of several lymphatic vessels. In newborns a lymphatic capsule The knots are still very delicate and thin, so they are hard to feel under the skin. Year old old lymph nodes can already be felt in almost all healthy children.

The maximum number of lymph nodes appears to 10 year old. age In an adult, their total number is 420-460.

Assessment of the size and condition of the lymph nodes is carried out by feeling. It is necessary to probe the lymph nodes in all groups. (and their 15) - from the occipital to the popliteal. With a significant increase in lymphatic Nodes parents or a child can themselves pay attention to this symptom. At lymph node inflammation (lymphadenitis) due to the appearance of pain, children clearly indicate localization process.

Normally, healthy children usually feel no more three groups LU.

Should not be palpable:

  • chin;
  • supraclavicular;
  • subclavian;
  • chest;
  • elbow;
  • popliteal lymph nodes.

Signs of a normal condition of the lymph nodes:

  • their size does not exceed the diameter of a small pea,
  • they are single
  • soft elastic consistency.
  • mobile,
  • not connected to the skin and to each other (doctors say “not brazed”),
  • painless.

Increasing the size of the LU with changing their consistency lymphadenopathy,quantitative increase in LU -polyadeny (from aden-gland, as previously LU was mistakenly considered glands).

Causes of lymphadenopathy in children:

  • infections;
  • tumor processes;
  • a special metabolic disorder, which is called “accumulation diseases”.

Local (regional) isolated lymph node enlargement always due to changes in the corresponding zone (region) of the body, from which comes lymph.

In all cases of unusual local increase The UL needs a thorough examination of the child to determine how generalization (distribution) of the process.

The stages of diagnosis with an isolated increase in LU:

  • clinical diagnosis. It lies in the fact that in the beginning the doctor diagnoses the child’s or parents ’complaints, clinical findings and results blood, urine, x-ray, etc.

  • tuberculin diagnosis. Necessary to eliminate the possibility of tuberculosis;

  • special (serological) blood tests if another infection is suspected;

  • a diagnostic technique, which doctors call “ex juvantibus”, what is meant by the diagnosis "on the effectiveness of treatment." Usually when isolated increase in any group of LUs prescribe antibacterial agents for 8-10 days. Improving the condition of the child and reducing the swelling of the LU regard as confirmation of the bacterial nature of the disease.

  • lymph node biopsy or puncture of the lymph node LU under the microscope. It is carried out in the most difficult diagnostic cases.

Features of the lymph nodes in certain areas:

  • enlargement of the occipital lymph nodes: found in inflammatory processes of the scalp (purulent rash, boils, osteomyelitis bones of the cranial vault, fungal infection). With rubella, in addition to the occipital, to a lesser extent, and other groups LU.

  • Increased parotid lymph nodes: characteristic of inflammation middle and outer ear, purulent inflammation of the scalp (pyoderma), lice, furunculosis. Often, these groups of LUs respond to infection. allergic rash in atopic dermatitis and eczema, especially when localized her behind the ears.

  • Swollen lymph nodes around the corner of the lower jaw and go back muscles of the neck.Develops in inflammatory processes in the nasopharynx. or after them: angina, infectious mononucleosis (as a manifestation of generalized process), with chronic tonsillitis and adenoid growths, with tuberculosis tonsils.

  • Swollen lymph nodes around the corner of the lower jaw and in the midline neck triangle: severe forms of angina, scarlet fever. For diphtheria tonsils there is a symmetrical increase in LU to apple size. However, they are elastic, painful. Edema of the surrounding tissue develops with an increase in the size of the neck. In the case of severe angina, acute inflammation of the LU may develop. lymphadenitis and even its purulent lesion. With cat scratch disease (causes a particular microorganism) may increase this group LU. Combination tonsillitis, lymphadenitis and peeling of the palms and feet is characteristic of streptococcal infections (streptococcal angina, scarlet fever). Some more reasons reactions of this group of LU: Kawasaki syndrome (combined with eye damage, skin, coronary arteries, fever, rash), toxoplasmosis, blood tumors and lymphatic systems (Hodgkin's disease - Hodgkin's disease, non-Hodgkin's lymphoma - Lymphosarcoma).

  • Swollen lymph nodes in the lateral triangle neck may be a sign of infection in the nasopharyngeal cavity, tuberculosis lymph nodes, tumors.

  • An enlarged lymph node in the submental zone develops. with an abscess in the areas of the jaw, with the defeat of the front teeth - incisors, stomatitis, inflammation of the lower lip.

  • Enlarged submandibular lymph nodes characteristic of inflammation jaws due to damaged teeth, stomatitis and gingivitis (inflammation of the gums). After treatment with antibiotics LU decrease and restore their mobility. when feeling.

  • An increase in axillary lymph nodes occurs with infectious diseases of various causes in the area of ​​the arm and shoulder (purulent lesion skin, chicken pox). Unilateral increase in LU may develop after vaccination or injury to the hand, with cat scratch disease.

  • An enlarged lymph node is a sign of infection. on the hand or forearm.

  • An enlarged inguinal lymph node indicates infection lower limbs with its localization in the bones, muscles or on the skin. The the symptom appears when inflammation of the joints, with severe diaper flow dermatitis, with furunculosis in the buttocks, inflammation of the genital organs, after vaccination with BCG with the introduction of the vaccine in the thigh. Moreover, isolated an increase in LU during 3 months after BCG is normal, and longer persistence of the symptom is regarded as an indirect sign of reduction activity of the immune system or high virulence of the inoculum, or as an individual feature of the reactivity of the child. When biopsy such LUs can detect a large number of blood cells called macrophages. After BCG, LU can be saturated with lime and palpable through thin skin. for many years. In case of infection through the skin of the leg in case of cat scratch disease, a group of inguinal LUs also reacts.


Frequent injuries of the skin of the legs and feet, infection of these wounds in preschool children and school age lead to the fact that most of them in the groin area significantly enlarged LUs are clearly sensed. Such children are not considered sick. in the absence of other signs of pathology.
A lot of diseases start with an increase in LU in any one zone, and then LU increase in almost all groups.Such a picture observed in influenza, measles, rubella, infectious mononucleosis, viral pneumonia, viral hepatitis, eczema, congenital syphilis, toxoplasmosis, etc.
In addition to the LU, it is possible to lift the skin and feel under the skin. and other education. One of the reasons for this islymphangioma(parents more familiar is the close formation from blood vessels - hemangioma), mild swelling under the skin without clear boundaries. Localized lymphangioma mainly on the neck and can cause difficulties during childbirth, when swallowing and breathing. Often requires surgical treatment.

It must be remembered that the LUs are located in the chest and in the abdominal cavity.

Signs of an increase in LU in the chest:

  • respiratory disorders;
  • difficulty swallowing;
  • long hiccups

Reaction of LU in the abdominal cavityviral or bacterial the infection can manifest very severe abdominal pain, which sometimes requires a differential diagnosis with appendicitis.

Parents should be aware that when one or more enlarged LU in one group, you need to carefully examine the child and feel LU in other zones.It is impossible to warm the lymphatic knots.Children who have enlarged “glands” in most groups must be examined with the use of ultrasound of internal organs for assessment of the condition of the liver, spleen and lymph nodes of the abdominal cavity.

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  • Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

    Causes of lymphadenopathy in children

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