The thymus gland is called the central organ of the immune system, as well as the gland producing the internal secret. It is here that the precursor cells turn into T-lymphocytes, which are directly involved in cellular and humoral immunity. In addition, about 20 substances are secreted from this gland as a secret. This includes a variety of hormones and components required for normal metabolism.
The maximum mass of the thymus is achieved during the neonatal period, since this organ takes more than 4% of the weight of the child. Growth can take place during the first 15 years of a child's life, but then age-related involution is noted. As a result, glandular tissue turns into connective and fatty tissue.
Causes
Timomegaly in children, ICD-10 of which is E32, develops due to the presence of exogenous and endogenous factors, and in some cases they can be combined with each other. Quite often, this pathology has a direct connection with the burdened obstetric history of the mother. We are talking about abortions and miscarriages, as well as severe toxicosis during pregnancy and the presence of a Rhesus conflict. Modern doctors do not cancel the negative effect of drugs and alcohol on the thymus gland, which will subsequently lead to the development of thymomegaly.
What do the children look like?
If the thymus gland has increased very slightly, clinical manifestations may not be observed. In this case, they speak of an enlarged thymus gland syndrome. The expanded symptoms of the disease are observed with a significant increase.
Children with a diagnosis of thymomegaly can be distinguished because of the characteristic phenotypic features:
- body shape is round;
- poorly developed muscles;
- facial features are very large;
- eyes and hair are light;
- the increased dimensions differ in the transverse parameters of the body, especially such parts as the shoulders and chest, as well as the palms and feet, which are constantly frozen;
- lymph nodes are enlarged;
- the skin is pale, a pattern resembling marble appears on it, mild pigmentation and a rash are present.
Signs
Children with this disease are characterized by increased appetite, they are often obese or overweight.
Other diseases accompany the disease. First of all, these are endocrine-metabolic pathologies, which are manifested in the form of thyroid dysfunction or hypocorticism, hypoparathyroidism. Diabetes may develop. Hernias are detected: inguinal or umbilical.
Timomegaly is accompanied by a change in pressure, which leads to arterial hypotension, arrhythmia. Provoke the disease and such deviations that are associated with compression of vital organs. This is first of all:
- Trachea. In this case, there is a constant cough, shortness of breath disturbs, noisy breathing with wheezing appears.
- Nervus vagus. Its irritation leads to bradycardia, dysphonia, collapses.
- Neck vein swelling, cyanosis.
Underdevelopment of the genitals is noted. Girls suffer from hypoplasia of the uterus and vagina, in boys phimosis or cryptorchidism can be detected.
Enlarged are adenoids and tonsils. ARVI often occurs, accompanied by severe coughing.
How to recognize
Timomegaly in children under one year of age can be recognized by the following signs:
- they are usually born with a lot of weight;
- a congenital defect in the femur may be detected;
- weight may fluctuate: either sharply increased, or its decrease;
- all signs of rickets are determined;
- the skin is pale, but during crying acquires a bluish tint;
- too frequent regurgitation is observed;
- excessive sweating;
- venous mesh visible in the chest area;
- there is a cough for no apparent reason, if the baby is kept in a horizontal position, it intensifies;
- a high temperature keeps for a long time, up to 38 degrees;
- arrhythmia is observed.
There is also a violation of consecutive teething, the child lags behind in speech development, begins to walk late.
How are the degrees of thymomegaly in children determined?
In pediatric endocrinology, the stage of development of thymomegaly is detected by the method of special measurements and by the external state of the thymus gland, according to the indications of an x-ray.
To diagnose thymomegaly in a child, the cardiotymicothoracic index (CTTI) is used. This indicator will be calculated by the doctor, based on the X-ray. It is necessary to measure the ratio of the area of the vascular bundle in the bifurcation area of the trachea to the size of the chest cavity in the area of the diaphragm.
Also in pediatric endocrinology there is an option for identifying the stage of the disease, focusing on the area of the shadow of the gland, which is possible to fix with an x-ray.
Conventionally, a person has three anatomical parts of the chest. The degree of timomegaly in a sick child is due to the fact that the area of the children's chest affects the level of growth of the thymus gland.
What are the indicators?
The following degrees of growth of the thymus are distinguished:
- 1 degree. The KKTI index is in the range of 0.33-0.37 units, the thymus gland in the upper third of the chest.
- 2 degree. The CCTI index is in the range of 0.37-0.42 units, the organ occupies an area of no more than 2/3 of the children's chest.
- 3 degree. The CCTI index is higher than 0.42 units, iron occupies an area of 2/3 or more of the chest area.
Diagnostics
One of the most objective methods for the recognition of thymomegaly is considered research using x-ray and ultrasound. Examination, palpation and percussion are used at the initial stage of diagnosis. An important factor in this is the experience of the doctor.
When establishing thymomegaly using x-ray diagnostics, it should be taken into account that, as a standard, the shadow visibility of the thymus does not go beyond the shadow projection of the child’s heart and vascular bundle. This situation applies to children of different ages.
Studies conducted by scientists have revealed the limiting norms of weight and volume of the thymus, beyond which is a manifestation of thymomegaly. Most accurately, these indications are established using ultrasound, during which the subject of the study is the thymus gland, abdominal organs and adrenal glands. An ultrasound of the thymus determines the degree of the disease.
In this case, laboratory blood tests are performed to exceed the norm of T-lymphocytes, hormones, a cardiogram is prescribed.
Studies of this disease revealed a decrease in the immunity of the child's body and a high susceptibility of the child to acute respiratory viral infections, therefore, when making a diagnosis, the history of the child is studied.
About problem
The thymus or thymus gland is an organ of lymphocytopoiesis in which lymphoid cells are formed that are responsible for the work of the child’s immune system. The thymus in childhood has a maximum size. Timomegaly is a disease associated with an increase in the size and weight of the named organ, it manifests itself in children from a very young age.
Children with thymomegaly, as already mentioned, are distinguished by overweight, increased appetite, a lack of development of muscle tissue, a change and underdevelopment of the forms of the genitals, a violation in the processes of eruption of milk teeth, a delay in development, speech defects.
The thymus gland compresses the vital organs of the child, which can be manifested in bloating of veins on the neck, shortness of breath, coughing and bluish skin color. In some cases, the disease can occur without any pronounced symptoms.
How is the therapy going?
Drug treatment of thymomegaly in children, the symptoms of which are higher, is prescribed by a pediatrician, based on the degree and severity of the disease and on the basis of the conclusions of the immunologist and endocrinologist. In medical practice, therapeutic treatment of mild forms of thymomegaly is not performed. It is recommended that the child adhere to a balanced diet, not be subjected to stress and protect himself from colds, regularly visit a pediatrician. Breastfeeding is indicated for newborns.
At the second stage of the disease, they are prescribed adaptogens and biostimulants based on plant components that can increase the body's resistance to harmful environmental factors.
In some cases, drugs are prescribed based on extracts from the thymus gland of cattle.
With the development of adrenal insufficiency in a child, injections of potassium solutions and cardiac glycosides are administered.
In the last stage of the disease and in the preoperative period, the administration of steroid hormones of glucocorticoids is prescribed: prednisone and hydrocortisone. Dosage is selected individually.
In order not to provoke the degeneration of thymomegaly into more serious diseases, regular monitoring of the child’s health and the prescribed treatment is necessary.
Prevention
Most often, a child develops a thymus of a normal size by the age of six, but still the child should be registered with such doctors as a pediatrician, immunologist and endocrinologist, as well as undergo regular preventive examinations.
Prevention of the disease can be the correct and thorough planning and conduct of labor, and this is maintaining a healthy lifestyle, before planning the baby and during pregnancy, passing all the necessary examinations both during pregnancy and after, already to the newborn. It is desirable to breast-feed a baby, since a large amount of antibodies and other useful substances are found in mother’s milk, due to which the baby will undergo the correct development.
While breastfeeding, the mother should avoid stress and an unhealthy lifestyle. If the child is on artificial feeding, then you should consult a doctor who will advise a quality mixture.
In the house you need to observe the correct microclimate, often carry out wet cleaning and ventilate. If the child has a thymus gland enlarged, then parents need to protect him from stressful situations, as well as from contacts with infected people.