The human lymphatic system acts as a kind of filter for the purification and removal of toxic substances and toxins. It is formed from vessels and nodes through which lymph flows. The disruption of the functioning of this system leads to dangerous consequences and causes serious harm to the body. Lymphadenopathy is considered the first sign of a disease.
Disease feature
Reactive lymphadenopathy is a pathological condition characterized by an increase in lymph nodes under the influence of provoking factors. Macrophages and lymphocytes that are in the lymph nodes eliminate the microorganisms entering the system, while absorbing dead cells.
With the penetration of pathogens, lymphoid tissues too actively produce antibodies and grow quite quickly. Lymphadenopathy can be a short-term response to an ongoing infectious process or be a sign of many pathologies that are completely different in nature, treatment methods and clinical signs. Absolutely any deviations or diseases can provoke a serious proliferation of lymphoid tissues.
Reactive lymphadenopathy can be localized in only one area or affect several departments. In addition, it can proceed in isolation or be part of a generalized process.
Reactive lymphadenopathy (ICD-10 code R59) refers to very serious pathologies and can trigger the development of malignant neoplasms. It is worth noting that there are many reasons for its occurrence, and it is established after the examination. The most common is the presence of viruses in the body, fungus, trauma. In children, a similar pathology also covers the abdominal cavity and occurs when infected with viruses and bacteria.
Forms of the disease
Depending on the degree of prevalence and localization of enlarged lymph nodes, several variants of the course of reactive lymphadenopathy are distinguished, in particular, such as:
- local
- regional;
- generalized.
Local lymphadenopathy is characterized by an increase in one of the groups of lymph nodes. This type of course can include an increase in a single node of the occipital group with rubella or submandibular - with gingivitis.
Regional lymphadenopathy - an increase in several lymph nodes in one or adjacent groups. For example, this may be an increase in the nodes of the posterior cervical group, may indicate the occurrence of an infection of the scalp, the anterior cervical infection of the respiratory system, behind the ear - otitis media. It is worth noting that the defeat of the lymph nodes of the supraclavicular group is almost never reactive. This symptom may indicate the metastasis of breast tumors or lymphogranulomatosis.
Generalized lymphadenopathy - an increase in lymph nodes in several groups at once. With this variant of the disease, not only peripheral nodes can increase, but also visceral ones. A common cause of this disorder is HIV infection. Retroperitoneal lymphadenopathy in combination with an increase in the nodes of the abdominal cavity, as well as inguinal and axillary nodes can be a sign of Hodgkin's lymphoma.
Developmental stages
The stages of reactive lymphadenopathy are divided into:
In addition, all of these forms can be tumor and non-tumor. It is worth noting that the process of the development of the disease can occur in absolutely any part of the lymphatic system.
The course of the disease in children
Currently, reactive lymphadenopathy of the cervical lymph nodes in children is increasingly common. This is provoked by the deterioration of the environmental situation and the increasing incidence of infectious processes. Lymph nodes can increase against the background of diseases such as infectious mononucleosis, scarlet fever, lymphogranulomatosis.
It is worth considering that before the child reaches 12 years of age, his lymphatic system is considered not mature enough, despite the fact that it begins to form in the first months of gestation. As a result of this, lymphadenopathy often occurs in childhood.
Upon visual inspection of the newborn, the detection of easily palpable lymph nodes indicates an increase in them, since at this age they are usually not palpable. The first year of the baby’s life is considered the most critical, since at this age the largest nodes are often enlarged.
At a more mature age in children after 3 years, no more than 3 groups of superficial lymph nodes should be determined by palpation. Equally often in childhood, lymphadenopathies are observed, resulting from the occurrence of systemic pathologies of connective tissue and with immunodeficiency. Timely diagnosis for treatment and a favorable prognosis are very important. Quite rarely, lymphadenopathy in children develops with helminthic invasion and allergies.
Changes in the lymph nodes in the neck are always accompanied by the occurrence of inflammatory changes in the oral cavity, as well as an increase in the spleen and thymus. Reactive cervical lymphadenopathy is often a manifestation of gum disease.
To determine the chronic source of infection, it is necessary to take into account the features of the normal fluid flow from a certain anatomical region. If a child older than 1 month has a stable generalized lymphadenopathy, which is combined with fever, diarrhea, candidiasis, dermatitis, then most likely he has AIDS.
Damage to the lymphatic system can be benign and malignant. The cancerous tumor is lymphosarcoma.
Causes of occurrence
Patients who have been diagnosed with this disease need to know what lymphadenopathy is. Symptoms and treatment in adults and children of this disease can be very different, it all depends on the form of the course of the disease, and the causes of the pathology are almost the same.
Overgrowth of nodes can be associated with various kinds of infectious and non-infectious factors. Often, such a syndrome is of an infectious origin. Among the main causes of reactive cervical lymphadenitis, it is necessary to distinguish such as:
- viruses;
- bacteria
- fungi;
- chlamydia
- parasitic infections;
- mononucleosis.
Often, the disease is associated with infections of the oral cavity. It is usually formed in children and adolescents if they have childhood infections. This is due to the insufficient maturity of the immune system, which is far from always able to normally respond to various kinds of stimuli.
Children most at risk of developing lymphadenopathy are unvaccinated against measles, diphtheria, rubella, and mumps. These diseases are mainly accompanied by an increase in the size of the anterior lymph nodes.
However, in some cases, the pathology is in no way associated with infections and may be a sign of oncological processes, namely:
- lymphoma
- leukemia;
- neuroblastoma.
One of the main causes of the formation of hyperplasia can be non-specific infection. This is a pathology provoked by conditionally pathogenic microflora, constantly located in the human body.
The main symptoms
Reactive lymphadenopathy of the cervical lymph nodes is generally completely asymptomatic, however, sometimes there may be quite characteristic signs. In this case, the nodes increase, become tuberous, painful, swelling of the soft tissues appears. Outwardly, it looks like the formation of small seals and their redness.
Above the inflamed node, the temperature rises, and headache, chills, and weakness also appear. Rashes on the skin can form, a person quickly loses weight, his liver and spleen increase. Then other signs of reactive lymphadenopathy of the cervical lymph nodes join, depending on the cause of the formation of the underlying, provoking disease and the localization area of the pathological process.
Enlarged lymph nodes are clearly visible during a routine examination, and to clarify the degree of damage can be done by palpation. With inflammation of the tonsils, pain appears when swallowing, as well as head movement. In the event of the first signs of lymphadenopathy of the cervical lymph nodes in adults, it is necessary to visit a therapist and oncologist to determine the cause of the development of a pathological condition.
Diagnostics
If you suspect lymphadenopathy of the cervical lymph nodes, you need to visit a therapist who will diagnose and, if necessary, prescribe the appropriate treatment. At the initial examination, palpation of the affected area is performed. The doctor determines the localization of the pathological process, soreness and the consistency of the changed organ. Often, this technique allows you to make a preliminary diagnosis.
Since this syndrome can be triggered by a wide variety of diseases, an additional series of laboratory and instrumental studies is required, namely:
- blood analysis;
- analysis for HIV and hepatitis;
- ultrasound diagnostics;
- biopsy and histology;
- tomography, radiography.
Ultrasound will help determine the echoes of probable reactive lymphadenopathy of the lymph nodes of the gates of the liver, kidneys, and spleen. If there is a chance of lung damage, then radiography is required. All these manipulations help determine the cause of the disease and choose the tactics of the therapy.
Sometimes, an additional puncture of the affected lymph node may be necessary with a biopsy. This method helps to accurately determine the cause in connection with which the development of pathology occurred. For examination under local anesthesia, a very thin needle is used to puncture and collect a piece of tissue. This procedure makes it possible to timely detect metastases in the affected area, to detect the course of the purulent process.
Disease treatment
A full treatment for lymphadenopathy can only be prescribed by a doctor after diagnosing and establishing the exact cause of the disease. Initially, you need to eliminate the provoking factor.
For viral infections, the doctor must prescribe antiviral therapy (Lavomax, Kagocel, Cycloferon), as well as drugs that strengthen the immune system (Immunal, Ribomunil, Amiksin). The bacterial form is treated with antibiotics (Summamed, Amoxicillin, Ceftriaxone, Augmentin), which are selected taking into account the sensitivity of the pathogen to them.
The tuberculosis type of the disease requires the use of anti-TB drugs in a hospital setting. Basically prescribed Ethambutol or Isoniazid. In some cases, reactive lymphadenopathy can occur on its own after 4-6 weeks from the moment of its occurrence, if the cause of its occurrence is eliminated.
If after this time there are no signs of a decrease in lymph nodes, then a biopsy is required. In case of pain, symptomatic treatment is indicated by taking analgesics. In the presence of purulent formations, the doctor prescribes an opening of the nodes and drainage.
In children, in some cases, the cervical lymph nodes may remain enlarged for a long time. In this case, you just need to watch them. If there is a constant increase in the nodes, despite the prescribed treatment for lymphadenopathy of the cervical lymph nodes in adults, it is important to urgently visit a doctor, as this can be a sign of the development of a cancerous tumor and requires urgent intervention and a course of chemotherapy.
To reduce the time course of the disease will help lymphatic drainage massage, which must be performed regularly.
If the disease was triggered by the presence of malignant tumors and in the presence of metastases, then, as prescribed by the oncologist, a course of chemotherapy, surgery or radiation therapy is carried out. In some cases, all these techniques are applied comprehensively.
Removal of tonsils is required only if all conservative methods of therapy have been exhausted and do not bring the desired result. It is proved that in addition to the barrier function that prevents the penetration of microbes, the glands also play an important role in the puberty of girls. Their early removal can lead to lag. In addition, in adulthood, a woman may have problems with bearing a child.
In allergic conditions that led to the development of lymphadenopathy, antihistamines are prescribed (Zodak, Zirtek, Fenistil), and they also carry out the removal of the allergen. In case of HIV infection, the patient’s immunity is initially evaluated and, if necessary, antiretroviral therapy is carried out aimed at suppressing the human immunodeficiency virus. With mechanical injuries that led to the development of the disease, painkillers are prescribed, complete rest is observed, and surgery is performed if necessary.
Due to the fact that the lymphatic tissue is prone to the rapid spread of inflammation, with absolutely any form of lymphadenopathy, it is necessary to use local treatment agents with caution, in particular, such as alcohol rubbing, warming compresses. In the presence of tumors, all these manipulations are strictly contraindicated, as they create the necessary conditions for the spread of cancer cells.
You can simply treat the affected lymph node with antiseptic ointments. However, they must be used necessarily in combination with antibacterial agents.
Possible complications
In case of untimely treatment, quite dangerous consequences and complications can arise, in particular, such as:
- purulent fusion of the enlarged node, the formation of abscesses, fistulas;
- vein thrombophlebitis in the affected area;
- bleeding;
- violation of the outflow of lymph;
- sepsis.
With the timely determination of the provoking factor and the correct therapy, it is possible to cope with a similar problem and avoid unpleasant consequences.
Prophylaxis
It is worth noting that specific measures to prevent the occurrence of this disease do not exist. However, you can include measures to prevent the development of the disease and the saturation of the body with toxic substances, which lead to an increase in lymph nodes. Be sure to lead the right lifestyle and give up bad habits.
Lymphadenopathy indicates the occurrence of pathological processes in the body. These may be signs of a simple SARS or more serious diseases, including malignant neoplasms. That is why the appearance of any seals or bumps in the area of the lymph nodes should be the reason for an immediate visit to the doctor and a thorough examination.
Treatment Reviews
It is very important to understand exactly what it is - lymphadenopathy. Symptoms, treatment in adults and reviews regarding therapy should be studied first. Medication has proven itself well. Patients say that the drugs "Valavir" and "Neovir" help. These funds act quickly and efficiently, which allows you to get rid of the existing problem.
Many patients say that the sooner treatment has been started, the better the effect can be achieved.