Características clínicas e histológicas de adenopatías en pacientes pediátricos / Clinical and histological characteristics of adenopathies in paediatric patients

Introducción: Las adenopatías son una causa muy frecuente de consulta en la población infantil, estando presente hasta en el 44% de los niños menores de 5 años. En algunos casos se requiere la toma de biopsias ganglionares para esclarecer el diagnóstico. Objetivo: Describir las características clínicas e histopatológicas de pacientes pediátricos con adenopatías sometidos a biopsias ganglionares. Pacientes y método: Estudio descriptivo, retrospectivo. Se incluyó la totalidad de los niños menores de 15 años a los que se les realizó biopsia ganglionar en hospital de alta complejidad en un periodo de 4 años. Se evaluaron las características demográficas, clínicas y de laboratorio de los pacientes, así como el diagnóstico histopatológico de las biopsias realizadas. Resultados: Sesenta y un niños, 54,1%, fueron del sexo masculino, mediana de edad de 6 años. El diagnóstico patológico más frecuente fue hiperplasia reactiva (50,8%), seguido de enfermedad neoplásica (27,9%), enfermedad granulomatosa crónica (4,9%) e infección bacteriana (3,3%). De las enfermedades neoplásicas, el linfoma de Hodgkin fue el más común, siendo su localización más frecuente la cervical (60,6%). Conclusiones: Con este estudio se demuestra la importancia de realización de diagnósticos diferenciales en el abordaje de pacientes con adenopatías. Al igual que lo reportado en la literatura mundial, la etiología benigna es la causa más común de adenopatías en niños.

Background: Lymphadenopathy is a common cause for medical consultation in the child population, accounting for up to 44% in children under 5 years old. In some cases, it is required to take lymph node biopsy specimens in order to clarify the diagnosis. Objective: To describe the clinical and histological features of paediatric patients with lymphadenopathy and lymph node biopsies. Patients and method: Descriptive and retrospective study conducted in Medellin (Colombia) in a fourth-level hospital between January 1st of 2009 and December 31st of 2012. In the study, lymph node biopsy specimens were taken from children under 15 years old. Demographic, clinical and laboratory features, and characteristics of the patients were evaluated, as well as the histopathological diagnosis of the lymph node biopsies. Results: From the child population, 61 children met the eligibility criteria and 33 (54.1%) of them were male with an average age of 6 years old. The most common pathological diagnoses in the study group were as follows: reactive hyperplasia (50.8%), neoplasms (27.9%), chronic granulomatous disease (4.9%), and bacterial infection (3.3%). It could be concluded from the findings in the study that Hodgkin lymphoma is very common among the neoplastic diseases, with 18%, and the most frequent location was the neck with 60.6%. Conclusions: This study demonstrates the importance of performing a differential diagnosis when approaching patients with lymphadenopathy. As reported in the world medical literature, benign origin is the most common cause of lymphadenopathy in children.

[Clinical and histological characteristics of adenopathies in paediatric patients]. / Características clínicas e histológicas de adenopatías en pacientes pediátricos.

BACKGROUND: Lymphadenopathy is a common cause for medical consultation in the child population, accounting for up to 44% in children under 5 years old. In some cases, it is required to take lymph node biopsy specimens in order to clarify the diagnosis. OBJECTIVE: To describe the clinical and histological features of paediatric patients with lymphadenopathy and lymph node biopsies. PATIENTS AND METHOD: Descriptive and retrospective study conducted in Medellin (Colombia) in a fourth-level hospital between January 1st of 2009 and December 31st of 2012. In the study, lymph node biopsy specimens were taken from children under 15 years old. Demographic, clinical and laboratory features, and characteristics of the patients were evaluated, as well as the histopathological diagnosis of the lymph node biopsies. RESULTS: From the child population, 61 children met the eligibility criteria and 33 (54.1%) of them were male with an average age of 6 years old. The most common pathological diagnoses in the study group were as follows: reactive hyperplasia (50.8%), neoplasms (27.9%), chronic granulomatous disease (4.9%), and bacterial infection (3.3%). It could be concluded from the findings in the study that Hodgkin lymphoma is very common among the neoplastic diseases, with 18%, and the most frequent location was the neck with 60.6%. CONCLUSIONS: This study demonstrates the importance of performing a differential diagnosis when approaching patients with lymphadenopathy. As reported in the world medical literature, benign origin is the most common cause of lymphadenopathy in children.

Prúrigo nodular: presentación de un caso clínico / Nodular prurigo: case presentation

El Prúrigo Nodular de Hyde es una dermatosis crónica que cursa con lesiones papulares y nodulares muy pruriginosos. En su tratamiento se han empleado numerosos fármacos tópicos, intralesionales, sistémicos, crioterapia y fototerapia, habitualmente de forma combinada. A pesar de las numerosas opciones, muchos tratamientosresultan ineficaces y no existen protocolos estandarizados. Se presenta el caso de una mujer de 22 años con lesiones diseminadas en estado avanzado en miembros superiores e inferiores, quien muestra una franca mejoría de aproximadamente el60% en poco tiempo, con la combinación de tratamientos dermatológicos no tan agresivos como la Crioterapia y Capsaisina más la adición de un antidepresivo como la Trazodona. Además se realiza una breve revisión del tema.

Hyde’s Nodular Prurigo is a chronic dermathosis characterized by extremely itchy papular and nodular lesions. Concerning it’s treatment, a number of topical, intralesional and systemic medicines, along with cryotherapy and phototherapy have been used, usually in a concomitant way. In spite of the various options, many treatments lackefficacy and there are no standardized protocols. This manuscript’s the presentation of a clinical case concerning a 22-year-old woman with disseminated lesions in an advanced stage in both upper and lower limbs. The patient developed an important(60%) evolution of the clinical picture in little time with the combination of not-so-aggressive dermatological treatments such as cryotherapy and capsaine plus an antidepressant such as trazodone. A short literature review is performed.