OVERVIEW
OVERVIEW
Lymphadenopathy is a systemic granulomatous disease that can involve lymph nodes throughout the body. It may be asymptomatic and is mostly detected by the presence of enlarged lymph nodes in the pulmonary hilar veins on chest X-ray.
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Department of Medicine
Rheumatology, Dermatology, Respiratory Medicine, etc.
Clinical symptoms
Asymptomatic or only mild respiratory symptoms, enlarged superficial lymph nodes, rash, generalized lethargy, etc.
Hazards
It can lead to visual impairment, facial nerve paralysis, lung, bone and joint lesions. Depending on the organs involved, the type and degree of harm is determined.
Examination
Blood calcium test, blood routine, X-ray, histopathologic examination, etc.
Diagnosis
Diagnosis can be made on the basis of clinical manifestations such as enlarged lymph nodes combined with X-rays and histopathologic examination.
Treatment principle
Hormones and other medications are given in combination with symptomatic treatment.
Curability
Symptoms can be relieved after treatment.
Dietary advice
Normal diet, maintain reasonable, balanced, comprehensive and sufficient nutrition.
Etiology
Epidemiology
The prevalence varies widely around the world, ranging from 10/100,000 to 40/100,000 per 100,000 population.
Etiology
The cause is unknown and may be related to autoimmune dysfunction.
Symptoms and Diagnosis
Typical symptoms
1. Enlarged lymph nodes: in addition to the enlarged mediastinal lymph nodes, there may be enlarged superficial lymph nodes all over the body, with no pressure and pain, and without adhesion. 2. Rash: more than 1/3 of the patients have special skin changes, and various kinds of sarcomatoid granulomas can be seen, most of them are seen on the face. Nodular erythema is also common as an early symptom of the disease. The rash may be scratchy.3. Ocular symptoms: keratitis, iritis, iridocyclitis, uveitis and glaucoma are more common. Ultimately, it can lead to uveal fibrosis and visual impairment.4. Salivary gland enlargement: it is painless enlargement of parotid and other salivary glands, combined with uveitis, facial nerve palsy and fever.5. Lung lesions: enlarged lymph nodes in hilar and peri-tracheal area, and granulomatous nodules or dot-like shadows in the lung field. When granulomas spread all over the alveoli, both lungs may show flocculent shadows, with occasional cough and chest pain.6. Bone and joint lesions: skeletal changes are more common in the hands and feet, with mild pain and dyskinesia, multiple cystic changes on X-ray, thickening of synovial membrane, and tendon sheaths are involved.
Diagnostic basis
According to clinical symptoms and X-ray examination, surrounding lymph nodes and skin lesions should be taken for histopathologic examination for diagnosis in suspicious patients. Multiple tissue biopsies from different parts of the body can increase the positive diagnosis rate.
Treatment
Treatment guidelines
Improvement of symptoms through hormone and other medications, symptomatic treatment, etc.
Drug therapy
Treatment with renal corticosteroids is generally advocated, and antibiotics can be used if there is an infection. Anti-malarial drug hydroxychloroquine sulfate can control the skin nodularity and mucous membrane damage. Other immunosuppressants such as methotrexate, azathioprine, and cyclophosphamide can be used in patients with poor symptom control on hormone therapy alone and in patients who need to reduce their hormone dosage.
Other treatments
The use of monoclonal antibody biologics against tumor necrosis factor TNF may improve lung function.
Prognosis
With treatment, the prognosis can be improved.
Nursing care
Daily care
1. Regular life, ensure sufficient sleep, combine work and rest, avoid excessive fatigue. 2. Pay attention to warmth, avoid catching cold, prevent respiratory tract infections. 3. Strengthen exercise, enhance physical fitness. 4. Follow the doctor’s instructions, take medication on time, and have regular review.
Diet regulation
Normal diet, maintain reasonable, balanced, comprehensive and sufficient nutrition. Diet should be light and easy to digest.