Perihepatic lymphadenopathy in children with chronic viral hepatitis
Identifieur interne : 007C38 ( Ncbi/Merge ); précédent : 007C37; suivant : 007C39Perihepatic lymphadenopathy in children with chronic viral hepatitis
Auteurs : Dagmar Schreiber-Dietrich [Allemagne] ; Margret Pohl [Allemagne] ; Xin-Wu Cui [Allemagne] ; Barbara Braden [Royaume-Uni] ; Christoph F. Dietrich [Allemagne] ; Liliana Chiorean [Allemagne, France]Source :
- Journal of Ultrasonography [ 2084-8404 ] ; 2015.
Abstract
To assess whether lymph node enlargement in the hepatoduodenal ligament occurs in children with chronic viral hepatitis B and C in comparison to healthy controls.
In 49 patients with chronic viral hepatitis (38 with chronic hepatitis B, 11 with chronic hepatitis C, 31 male, 18 female; age range 1 to 17 years), and in 51 healthy controls (25 male, 26 female; age range 4 to 16 years), the total perihepatic lymph node volume was assessed using transabdominal ultrasonography as previously described in adult patients.
Adequate visualization of the liver hilum was achieved in 46/49 (94%) pediatric patients with chronic viral hepatitis and in 46/51 (90%) pediatric healthy controls. In patients with adequate liver hilum visualization, enlarged perihepatic lymph nodes (longitudinal diameter >14 mm) were detected in 32/46 (70%) patients with chronic viral hepatitis and in 5/46 (11%) healthy controls. The total perihepatic lymph nodes volume [mean ± SD] was 1.0 ± 1.2 mL (0.1–5.4 mL) in patients with chronic viral hepatitis and 0.1 ± 0.1 mL (0.0–0.4 mL) in healthy controls (
Transabdominal ultrasound can detect lymph nodes within the hepatoduodenal ligament not only in adults but also in children. Paediatric patients with chronic viral hepatitis have significantly enlarged perihepatic lymph nodes compared to controls. Therefore, sonographic assessment of perihepatic lymphadenopathy might be a non-invasive diagnostic tool to screen paediatric patients for chronic viral hepatitis.
Url:
DOI: 10.15557/JoU.2015.0012
PubMed: 26676184
PubMed Central: 4579752
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type="main">Perihepatic lymphadenopathy in children with chronic viral hepatitis</title><author><name sortKey="Schreiber Dietrich, Dagmar" sort="Schreiber Dietrich, Dagmar" uniqKey="Schreiber Dietrich D" first="Dagmar" last="Schreiber-Dietrich">Dagmar Schreiber-Dietrich</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim</wicri:regionArea><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="AF0002">Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation></author><author><name sortKey="Pohl, Margret" sort="Pohl, Margret" uniqKey="Pohl M" first="Margret" last="Pohl">Margret Pohl</name><affiliation wicri:level="3"><nlm:aff id="AF0003">Zentrum der Kinderheilkunde Abteilung für Kindergastroenterologie und Mukoviszidose, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Zentrum der Kinderheilkunde Abteilung für Kindergastroenterologie und Mukoviszidose, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation></author><author><name sortKey="Cui, Xin Wu" sort="Cui, Xin Wu" uniqKey="Cui X" first="Xin-Wu" last="Cui">Xin-Wu Cui</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim</wicri:regionArea><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion></affiliation></author><author><name sortKey="Braden, Barbara" sort="Braden, Barbara" uniqKey="Braden B" first="Barbara" last="Braden">Barbara Braden</name><affiliation wicri:level="3"><nlm:aff id="AF0004">Translational Gastroenterology Unit, Oxford University Hospitals, Headley Way, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Translational Gastroenterology Unit, Oxford University Hospitals, Headley Way, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Dietrich, Christoph F" sort="Dietrich, Christoph F" uniqKey="Dietrich C" first="Christoph F." last="Dietrich">Christoph F. Dietrich</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim</wicri:regionArea><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="AF0002">Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main</wicri:regionArea><placeName><region type="land" nuts="1">Hesse (Land)</region><region type="district" nuts="2">District de Darmstadt</region><settlement type="city">Francfort-sur-le-Main</settlement></placeName></affiliation></author><author><name sortKey="Chiorean, Liliana" sort="Chiorean, Liliana" uniqKey="Chiorean L" first="Liliana" last="Chiorean">Liliana Chiorean</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim</wicri:regionArea><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion><wicri:noRegion>Bad Mergentheim</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="AF0005">Département d'imagerie médicale, Clinique des Cévennes, Annonay, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Département d'imagerie médicale, Clinique des Cévennes, Annonay</wicri:regionArea><wicri:noRegion>Annonay</wicri:noRegion><wicri:noRegion>Annonay</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Ultrasonography</title><idno type="ISSN">2084-8404</idno><idno type="eISSN">2451-070X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Objective</title><p>To assess whether lymph node enlargement in the hepatoduodenal ligament occurs in children with chronic viral hepatitis B and C in comparison to healthy controls.</p></sec><sec id="st2"><title>Subject and methods</title><p>In 49 patients with chronic viral hepatitis (38 with chronic hepatitis B, 11 with chronic hepatitis C, 31 male, 18 female; age range 1 to 17 years), and in 51 healthy controls (25 male, 26 female; age range 4 to 16 years), the total perihepatic lymph node volume was assessed using transabdominal ultrasonography as previously described in adult patients.</p></sec><sec id="st3"><title>Results</title><p>Adequate visualization of the liver hilum was achieved in 46/49 (94%) pediatric patients with chronic viral hepatitis and in 46/51 (90%) pediatric healthy controls. In patients with adequate liver hilum visualization, enlarged perihepatic lymph nodes (longitudinal diameter >14 mm) were detected in 32/46 (70%) patients with chronic viral hepatitis and in 5/46 (11%) healthy controls. The total perihepatic lymph nodes volume [mean ± SD] was 1.0 ± 1.2 mL (0.1–5.4 mL) in patients with chronic viral hepatitis and 0.1 ± 0.1 mL (0.0–0.4 mL) in healthy controls (<italic>p</italic> < 0.05). A maximal lymph node diameter >14 mm identified patients with chronic viral hepatitis with 70% sensitivity and 89% specificity.</p></sec><sec id="st4"><title>Conclusion</title><p>Transabdominal ultrasound can detect lymph nodes within the hepatoduodenal ligament not only in adults but also in children. Paediatric patients with chronic viral hepatitis have significantly enlarged perihepatic lymph nodes compared to controls. Therefore, sonographic assessment of perihepatic lymphadenopathy might be a non-invasive diagnostic tool to screen paediatric patients for chronic viral hepatitis.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Braden, B" uniqKey="Braden B">B Braden</name></author><author><name sortKey="Faust, D" uniqKey="Faust D">D Faust</name></author><author><name sortKey="Ignee, A" uniqKey="Ignee A">A Ignee</name></author><author><name sortKey="Schreiber, D" uniqKey="Schreiber D">D Schreiber</name></author><author><name sortKey="Hirche, T" uniqKey="Hirche T">T Hirche</name></author><author><name sortKey="Dietrich, Cf" uniqKey="Dietrich C">CF Dietrich</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dietrich, Cf" uniqKey="Dietrich C">CF Dietrich</name></author><author><name sortKey="Zeuzem, S" uniqKey="Zeuzem S">S Zeuzem</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Ultrason</journal-id><journal-id journal-id-type="iso-abbrev">J Ultrason</journal-id><journal-id journal-id-type="publisher-id">JoU</journal-id><journal-title-group><journal-title>Journal of Ultrasonography</journal-title></journal-title-group><issn pub-type="ppub">2084-8404</issn><issn pub-type="epub">2451-070X</issn><publisher><publisher-name>Medical Communications Sp. z o.o.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26676184</article-id><article-id pub-id-type="pmc">4579752</article-id><article-id pub-id-type="publisher-id">0012</article-id><article-id pub-id-type="doi">10.15557/JoU.2015.0012</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Paper</subject></subj-group></article-categories><title-group><article-title>Perihepatic lymphadenopathy in children with chronic viral hepatitis</article-title><trans-title-group xml:lang="pl"><trans-title>Limfadenopatia węzłów chłonnych wątrobowych u dzieci z przewlekłym wirusowym zapaleniem wątroby</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name><surname>Schreiber-Dietrich</surname><given-names>Dagmar</given-names></name><xref ref-type="aff" rid="AF0001">1</xref><xref ref-type="aff" rid="AF0002">2</xref></contrib><contrib contrib-type="author"><name><surname>Pohl</surname><given-names>Margret</given-names></name><xref ref-type="aff" rid="AF0003">3</xref></contrib><contrib contrib-type="author"><name><surname>Cui</surname><given-names>Xin-Wu</given-names></name><xref ref-type="aff" rid="AF0001">1</xref></contrib><contrib contrib-type="author"><name><surname>Braden</surname><given-names>Barbara</given-names></name><xref ref-type="aff" rid="AF0004">4</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Dietrich</surname><given-names>Christoph F.</given-names></name><xref ref-type="aff" rid="AF0001">1</xref><xref ref-type="aff" rid="AF0002">2</xref></contrib><contrib contrib-type="author"><name><surname>Chiorean</surname><given-names>Liliana</given-names></name><xref ref-type="aff" rid="AF0001">1</xref><xref ref-type="aff" rid="AF0005">5</xref></contrib></contrib-group><aff id="AF0001"><label>1</label>Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany</aff><aff id="AF0002"><label>2</label>Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany</aff><aff id="AF0003"><label>3</label>Zentrum der Kinderheilkunde Abteilung für Kindergastroenterologie und Mukoviszidose, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany</aff><aff id="AF0004"><label>4</label>Translational Gastroenterology Unit, Oxford University Hospitals, Headley Way, Oxford, UK</aff><aff id="AF0005"><label>5</label>Département d'imagerie médicale, Clinique des Cévennes, Annonay, France</aff><author-notes><corresp id="cor1">Correspondence: Prof. Christoph F. Dietrich, MD, PhD, Innere Medizin 2, Caritas Krankenhaus, Uhlandstr. 7, D-97980 Bad Mergentheim, Germany. tel.: 49 7931 58 2201, fax: 49 7931 58 2290. e-mail: <email xlink:href="christoph.dietrich@ckbm.de">christoph.dietrich@ckbm.de</email></corresp></author-notes><pub-date pub-type="epub"><day>30</day><month>6</month><year>2015</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2015</year></pub-date><volume>15</volume><issue>61</issue><fpage>137</fpage><lpage>150</lpage><history><date date-type="received"><day>04</day><month>2</month><year>2015</year></date><date date-type="rev-recd"><day>01</day><month>4</month><year>2015</year></date><date date-type="accepted"><day>21</day><month>4</month><year>2015</year></date></history><permissions><copyright-statement>2015 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o. All rights reserved.</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (CC BY-NC-ND). Reproduction is permitted for personal, educational, non-commercial use, provided that the original article is in whole, unmodified, and properly cited.</license-p></license></permissions><abstract><sec id="st1"><title>Objective</title><p>To assess whether lymph node enlargement in the hepatoduodenal ligament occurs in children with chronic viral hepatitis B and C in comparison to healthy controls.</p></sec><sec id="st2"><title>Subject and methods</title><p>In 49 patients with chronic viral hepatitis (38 with chronic hepatitis B, 11 with chronic hepatitis C, 31 male, 18 female; age range 1 to 17 years), and in 51 healthy controls (25 male, 26 female; age range 4 to 16 years), the total perihepatic lymph node volume was assessed using transabdominal ultrasonography as previously described in adult patients.</p></sec><sec id="st3"><title>Results</title><p>Adequate visualization of the liver hilum was achieved in 46/49 (94%) pediatric patients with chronic viral hepatitis and in 46/51 (90%) pediatric healthy controls. In patients with adequate liver hilum visualization, enlarged perihepatic lymph nodes (longitudinal diameter >14 mm) were detected in 32/46 (70%) patients with chronic viral hepatitis and in 5/46 (11%) healthy controls. The total perihepatic lymph nodes volume [mean ± SD] was 1.0 ± 1.2 mL (0.1–5.4 mL) in patients with chronic viral hepatitis and 0.1 ± 0.1 mL (0.0–0.4 mL) in healthy controls (<italic>p</italic> < 0.05). A maximal lymph node diameter >14 mm identified patients with chronic viral hepatitis with 70% sensitivity and 89% specificity.</p></sec><sec id="st4"><title>Conclusion</title><p>Transabdominal ultrasound can detect lymph nodes within the hepatoduodenal ligament not only in adults but also in children. Paediatric patients with chronic viral hepatitis have significantly enlarged perihepatic lymph nodes compared to controls. Therefore, sonographic assessment of perihepatic lymphadenopathy might be a non-invasive diagnostic tool to screen paediatric patients for chronic viral hepatitis.</p></sec></abstract><trans-abstract xml:lang="pl"><sec id="st5"><title>Cel</title><p>Celem pracy była ocena występowania powiększonych węzłów chłonnych więzadła wątrobowo-dwunastniczego u dzieci z przewlekłym wirusowym zapaleniem wątroby typu B i C w porównaniu ze zdrową grupą kontrolną.</p></sec><sec id="st6"><title>Pacjenci i metoda</title><p>Objętość całkowitą węzłów chłonnych wątrobowych zbadano u 49 pacjentów z przewlekłym wirusowym zapaleniem wątroby (38 z przewlekłym wirusowym zapaleniem wątroby typu B, 11 z przewlekłym wirusowym zapaleniem wątroby typu C; 31 chłopców, 18 dziewcząt; wiek pacjentów od 1 do 17 lat) oraz u zdrowych dzieci stanowiących grupę kontrolną (25 chłopców, 26 dziewcząt; wiek od 4 do 16 lat) za pomocą ultrasonografii jamy brzusznej, zgodnie z poprzednim opisem dotyczącym dorosłych pacjentów.</p></sec><sec id="st7"><title>Wyniki</title><p>Poprawną wizualizację wnęki wątroby uzyskano u 46/49 (94%) dzieci z przewlekłym wirusowym zapaleniem wątroby oraz u 46/51 (90%) zdrowych dzieci z grupy kontrolnej. Wśród tych pacjentów powiększone węzły chłonne wątrobowe (o wymiarze podłużnym >14 mm) wykryto u 32/46 (70%) pacjentów z przewlekłym zapaleniem wątroby oraz 5/46 (11%) zdrowych dzieci z grupy kontrolnej. Objętość całkowita węzłów chłonnych wątrobowych (średnia ± SD) u pacjentów z przewlekłym wirusowym zapaleniem wątroby wynosiła 1,0 ± 1,2 ml (0,1–5,4 ml), natomiast w grupie kontrolnej 0,1 ± 0,1 ml (0,0–0,4 ml) (p < 0,05). Na podstawie maksymalnej średnicy węzłów chłonnych wynoszącej >14 mm zidentyfikowano pacjentów z przewlekłym wirusowym zapaleniem wątroby z czułością 70% i swoistością 89%.</p></sec><sec id="st8"><title>Wnioski</title><p>Badanie ultrasonograficzne jamy brzusznej pozwala na wykrycie węzłów chłonnych w obrębie więzadła wątrobowo-dwunastniczego nie tylko u osób dorosłych, ale również u dzieci. U dzieci z przewlekłym wirusowym zapaleniem wątroby występują znacznie powiększone węzły chłonne wątrobowe w porównaniu z grupą kontrolną. W związku z tym ocena ultrasonograficzna powiększenia węzłów chłonnych wątroby może stanowić nieinwazyjne narzędzie diagnostyczne do badań przesiewowych dzieci w kierunku przewlekłego wirusowego zapalenia wątroby.</p></sec></trans-abstract><kwd-group><kwd>ultrasonography</kwd><kwd>lymphadenopathy</kwd><kwd>chronic hepatitis</kwd><kwd>liver hilum</kwd><kwd>pediatric</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Allemagne</li><li>France</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>District de Darmstadt</li><li>Hesse (Land)</li><li>Oxfordshire</li></region><settlement><li>Francfort-sur-le-Main</li><li>Oxford</li></settlement></list><tree><country name="Allemagne"><noRegion><name sortKey="Schreiber Dietrich, Dagmar" sort="Schreiber Dietrich, Dagmar" uniqKey="Schreiber Dietrich D" first="Dagmar" last="Schreiber-Dietrich">Dagmar Schreiber-Dietrich</name></noRegion><name sortKey="Chiorean, Liliana" sort="Chiorean, Liliana" uniqKey="Chiorean L" first="Liliana" last="Chiorean">Liliana Chiorean</name><name sortKey="Cui, Xin Wu" sort="Cui, Xin Wu" uniqKey="Cui X" first="Xin-Wu" last="Cui">Xin-Wu Cui</name><name sortKey="Dietrich, Christoph F" sort="Dietrich, Christoph F" uniqKey="Dietrich C" first="Christoph F." last="Dietrich">Christoph F. Dietrich</name><name sortKey="Dietrich, Christoph F" sort="Dietrich, Christoph F" uniqKey="Dietrich C" first="Christoph F." last="Dietrich">Christoph F. Dietrich</name><name sortKey="Pohl, Margret" sort="Pohl, Margret" uniqKey="Pohl M" first="Margret" last="Pohl">Margret Pohl</name><name sortKey="Schreiber Dietrich, Dagmar" sort="Schreiber Dietrich, Dagmar" uniqKey="Schreiber Dietrich D" first="Dagmar" last="Schreiber-Dietrich">Dagmar Schreiber-Dietrich</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Braden, Barbara" sort="Braden, Barbara" uniqKey="Braden B" first="Barbara" last="Braden">Barbara Braden</name></region></country><country name="France"><noRegion><name sortKey="Chiorean, Liliana" sort="Chiorean, Liliana" uniqKey="Chiorean L" first="Liliana" last="Chiorean">Liliana Chiorean</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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