TY - JOUR
T1 - Characteristics of mesenteric lymphadenitis in comparison with those of acute appendicitis in children
AU - Gross, Itai
AU - Siedner-Weintraub, Yael
AU - Stibbe, Shir
AU - Rekhtman, David
AU - Weiss, Daniel
AU - Simanovsky, Natalia
AU - Arbell, Dan
AU - Hashavya, Saar
N1 - Publisher Copyright: © 2016, Springer-Verlag Berlin Heidelberg.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Mesenteric lymphadenitis (ML) is considered as one of the most common alternative diagnosis in a child with suspected acute appendicitis (AA). In this retrospective study, patients diagnosed with ML (n = 99) were compared in terms of demographic, clinical, and laboratory findings to patients diagnosed with AA (n = 102). This comparison was applied for both lymph nodes smaller and larger than 10 mm. When compared to patients with AA, patients with ML had significantly longer duration of symptoms prior to emergency department (ED) presentation (2.4 ± 2.6 vs 1.4 ± 1.4 days, P = 0.002) and multiple ED presentations (1.3 ± 0.7 vs 1.05 ± 0.3, P < 0.001) and had longer duration of stay in the ED (9.2 ± 5.9 vs 5.2 ± 4 h, P < 0.001), respectively. They also had significantly lower WBC (10.16 ± 4.7 × 103/dl vs 15.8 ± 4.4 × 103/dl, P < 0.001) with lymphocyte predominance (24.6 ± 14 vs 13 ± 8.7%, P < 0.001) and lower CRP levels (0.48 vs 1.6 mg/dl). Migration of pain (28 vs 7%), vomiting (62 vs 34%), and classic abdominal findings of AA (72 vs 20%) were all significantly more common for children with AA. When comparing lymph node size, no significant difference was found between those presenting with small and large nodes. Conclusion: This study highlights multiple clinical and laboratory findings that differentiate ML and AA. Moreover, the absence of any difference with regard to the lymph nodes size might suggest that lymph nodes enlargement is a non-specific finding.What is Known:• Mesenteric lymphadenitis is a very common diagnosis in children with suspected acute appendicitis.• Despite its prevalence, only few studies addressed the clinical characteristics of this clinical entity and their comparison with acute appendicitis.What is New:• Mesenteric lymphadenitis and acute appendicitis could be differentiated by multiple clinical and laboratory parameters.• No significant difference was found between those presenting with small and large lymph nodes.
AB - Mesenteric lymphadenitis (ML) is considered as one of the most common alternative diagnosis in a child with suspected acute appendicitis (AA). In this retrospective study, patients diagnosed with ML (n = 99) were compared in terms of demographic, clinical, and laboratory findings to patients diagnosed with AA (n = 102). This comparison was applied for both lymph nodes smaller and larger than 10 mm. When compared to patients with AA, patients with ML had significantly longer duration of symptoms prior to emergency department (ED) presentation (2.4 ± 2.6 vs 1.4 ± 1.4 days, P = 0.002) and multiple ED presentations (1.3 ± 0.7 vs 1.05 ± 0.3, P < 0.001) and had longer duration of stay in the ED (9.2 ± 5.9 vs 5.2 ± 4 h, P < 0.001), respectively. They also had significantly lower WBC (10.16 ± 4.7 × 103/dl vs 15.8 ± 4.4 × 103/dl, P < 0.001) with lymphocyte predominance (24.6 ± 14 vs 13 ± 8.7%, P < 0.001) and lower CRP levels (0.48 vs 1.6 mg/dl). Migration of pain (28 vs 7%), vomiting (62 vs 34%), and classic abdominal findings of AA (72 vs 20%) were all significantly more common for children with AA. When comparing lymph node size, no significant difference was found between those presenting with small and large nodes. Conclusion: This study highlights multiple clinical and laboratory findings that differentiate ML and AA. Moreover, the absence of any difference with regard to the lymph nodes size might suggest that lymph nodes enlargement is a non-specific finding.What is Known:• Mesenteric lymphadenitis is a very common diagnosis in children with suspected acute appendicitis.• Despite its prevalence, only few studies addressed the clinical characteristics of this clinical entity and their comparison with acute appendicitis.What is New:• Mesenteric lymphadenitis and acute appendicitis could be differentiated by multiple clinical and laboratory parameters.• No significant difference was found between those presenting with small and large lymph nodes.
KW - Abdominal pain
KW - Acute appendicitis
KW - Lymph nodes
KW - Mesenteric lymphadenitis
UR - http://www.scopus.com/inward/record.url?scp=85006351949&partnerID=8YFLogxK
U2 - 10.1007/s00431-016-2822-7
DO - 10.1007/s00431-016-2822-7
M3 - مقالة
C2 - 27987102
SN - 0340-6199
VL - 176
SP - 199
EP - 205
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 2
ER -