Application of ultrasound examination in the diagnostics of ENT-organs  chronic lymphoproliferative syndrome in the young children

Drozdova, M. V.; Larionova, S. N.; Tyrnova, E. V.

doi:10.18692/1810-4800-2021-6-48-54

2021

DOI: 10.18692/1810-4800-2021-6-48-54

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Application of ultrasound examination in the diagnostics of ENT-organs chronic lymphoproliferative syndrome in the young children

M. V. Drozdova¹,

S. N. Larionova²,

E. V. Tyrnova³

Abstract: The aim of study was to assess the diagnostic value of ultrasound diagnostics of chronic lymphoproliferative syndrome in the young children. 88 children aged 2–3 years with pathology of the lymphadenoid ring of the pharynx, accompanied by regional cervical lymphadenitis, needing surgery were examined. Endoscopy of the nasopharynx, otomicroscopy, impedance, ultrasound examination of cervical and submandibular lymph nodes, abdominal organs, complete blood count with a manual differential, ELISA to determine spec… Show more

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Features of the pathology of the lymphoid ring of the pharynx in children during the COVID-19 pandemic

2023

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Introduction. For many years, one of the problems in medicine that attracted the attention of specialists from different areas of medicine was herpes virus infection. There are many reasons for this, including the often persistent nature of the course, a wide variety of clinical manifestations and routes of transmission, and many target organs of this infection. The disease can proceed in different ways, it has both asymptomatic, mild and rather severe course. For otorhinolaryngologists, Epstein-Barr virus (EBV), cytomegalovirus (CMV) and herpes virus 6 (HHV-6) are the most relevant and important in the context of the treated site of the pathological process. Since the end of 2020, humanity has faced a new, previously unexplored viral infection – a new coronavirus infection. And just like the previously studied herpes virus infection, COVID-19 has a large number of clinical manifestations and affects a huge number of organs and organ systems.Aim. To determine the types of interplay between COVID-19 and herpesviruses (EBV, CMV, HHV-6) in children of different ages with abnormalities of the lymphoid ring of pharynx.Materials and methods. In the course of the study, a comprehensive examination was carried out and the results of examination of children with pathology of the lymphoid ring of the pharynx who had herpes virus infection and COVID-19 were analyzed.Results. The results of the study obtained in the course of the work are consistent with the data that the virus carrier. The presence of an infectious agent triggers the production of macrophages and leads to clonal selection of T and B cells. Further, lymphocytes are transformed into lymphoblasts, which are capable of division and their transformation into plasma and B-memory cells occurs. As a result of this process, hypertrophy of the lymphoid tissue occurs and its reactive activity increases. (persistent herpesvirus infection) is one of the important causes of lymphoid proliferation in children. The combination of antigenic load and immaturity of the immune system in children is accompanied by an increase in the activity of lymphoid tissue and its compensatory activity.Conclusions. Past mild and asymptomatic COVID-19 can contribute to the reactivation of lymphotropic herpesviruses, first of all EBV, in 55-65% of children of preschool and school age.

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Features of the pathology of the lymphoid ring of the pharynx in children during the COVID-19 pandemic

2023

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Features of preoperative diagnosis of chronic lymphoproliferative syndrome of ENT organs in young children

2023

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Introduction. To determine the tactics of management of chronic lymphoproliferative syndrome in young children, a comprehensive examination is necessary. Herpesvirus infection (HVI) plays an important role in the etiology of hypertrophy of lymphoid formations of the pharynx.Purpose. To evaluate the results of preoperative diagnosis of chronic lymphoproliferative syndrome in children in early childhood.Materials and methods. In 96 patients aged 1 to 3 years 11 months with lymphoproliferative syndrome more than 3–6 months, endoscopy, otomicroscopy, impedance, ultrasound examination of abdominal organs, cervical and submandibular lymph nodes, serological and molecular genetic analyses of markers of EBV, CMV, HCV-6 in the blood; PCR in pharyngeal tonsil scrapings were performed.Results and discussion. The clinical picture in children with chronic lymphoproliferative syndrome of younger age was dominated by complaints of difficulty in nasal breathing, snoring in 42% of children, recurrent otitis in 58%, manifestations of asthenovegetative and intoxication syndromes and frequent acute respiratory viral infections in 70% of patients. A high degree of infection of children of the younger age group was revealed – HCV-6 in 87%, CMV in 63% of children, 46% – EBV. And high activity of the infectious process in 31% of patients for all three GVI, more often for EBV in 27%. A combination of two or three GVI was detected in 83% of patients. During instrumental examination, a high degree of hypertrophy of the nasopharyngeal tonsils (adenoid vegetations of 2–3 degrees – 67% and 3 degrees – 18%, combined with hypertrophy of the palatine tonsils in 27% of cases), an increase in neck lymph nodes of more than 16mm, including lymph node packs in 28% of younger children and reactive hepatosplenomegaly in 17.7% of patients.Conclusion. To determine the tactics of management of chronic lymphoproliferative syndrome in young children, it is important to assess the severity of lymphoproliferative syndrome according to the clinical picture and instrumental research methods (nasopharyngeal endoscopy, ultrasound examination of neck and abdominal lymph nodes) in combination with laboratory data and characteristics of the stage of activity of the infectious process of herpesvirus etiology.

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Application of ultrasound examination in the diagnostics of ENT-organs chronic lymphoproliferative syndrome in the young children

Cited by 2 publications

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Features of the pathology of the lymphoid ring of the pharynx in children during the COVID-19 pandemic

Features of the pathology of the lymphoid ring of the pharynx in children during the COVID-19 pandemic

Features of preoperative diagnosis of chronic lymphoproliferative syndrome of ENT organs in young children

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