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Perihepatic lymphadenopathy in children with chronic viral hepatitis

Dagmar Schreiber-Dietrich1, Margret Pohl2, Xin-Wu Cui3

  • 1Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany ; Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.

Journal of Ultrasonography
|December 18, 2015
PubMed

Insights

Children with chronic viral hepatitis B and C show significantly enlarged perihepatic lymph nodes compared to healthy children. Ultrasound can identify this lymphadenopathy, suggesting it as a potential screening tool for pediatric viral hepatitis.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Medical Imaging

Background:

  • Chronic viral hepatitis B and C are significant global health concerns in children.
  • Enlarged lymph nodes in the hepatoduodenal ligament (perihepatic lymphadenopathy) have been observed in adults with viral hepatitis.
  • The presence and significance of perihepatic lymphadenopathy in pediatric viral hepatitis are not well-established.

Purpose of the Study:

  • To investigate the occurrence of lymph node enlargement in the hepatoduodenal ligament in children diagnosed with chronic viral hepatitis B and C.
  • To compare the perihepatic lymph node volume in pediatric patients with chronic viral hepatitis to that of healthy pediatric controls.

Main Methods:

  • Transabdominal ultrasonography was employed to assess the total perihepatic lymph node volume in 49 children with chronic viral hepatitis (B or C) and 51 healthy controls.
  • Measurements included longitudinal lymph node diameter and total volume, with specific criteria for lymph node enlargement (>14 mm diameter).

Main Results:

  • Perihepatic lymphadenopathy (longitudinal diameter >14 mm) was detected in 70% of pediatric patients with chronic viral hepatitis versus 11% of healthy controls.
  • The mean total perihepatic lymph node volume was significantly greater in patients with chronic viral hepatitis (1.0 ± 1.2 mL) compared to controls (0.1 ± 0.1 mL) (p < 0.05).
  • A maximal lymph node diameter >14 mm demonstrated 70% sensitivity and 89% specificity in identifying pediatric patients with chronic viral hepatitis.

Conclusions:

  • Transabdominal ultrasound is effective in visualizing and assessing lymph nodes within the hepatoduodenal ligament in children.
  • Pediatric patients with chronic viral hepatitis exhibit significantly enlarged perihepatic lymph nodes compared to their healthy peers.
  • Sonographic assessment of perihepatic lymphadenopathy may serve as a valuable, non-invasive screening method for identifying pediatric patients with chronic viral hepatitis.
Abstract

Keywords:
chronic hepatitisliver hilumlymphadenopathypediatricultrasonography

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