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Clinical Evaluation and Outcomes of Mesenteric Lymphadenopathy in Children: A Cross-Sectional Analysis
Bekir Yukcu1, Zeynep Yildiz Yildirmak2, Alper Ozel3
1Department of Pediatric Cardiology, Giresun Obstetric and Pediatric Training and Research Hospital, Giresun, Türkiye.
Insights
Pediatric mesenteric lymphadenopathy (ML) is typically benign and self-limiting, often resolving without intervention. Careful monitoring is key, as most cases of ML resolve naturally, reducing the need for unnecessary treatments.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Clinical Pediatrics
Background:
- Mesenteric lymphadenopathy (ML) in children presents a diagnostic challenge, often mimicking more serious conditions.
- Understanding the etiology and natural history of ML is crucial for appropriate clinical management.
Purpose of the Study:
- To evaluate the causes, clinical features, and outcomes of pediatric mesenteric lymphadenopathy.
- To determine the clinical significance and optimal management strategies for ML in children.
Main Methods:
- A cross-sectional study including 106 pediatric patients (1 month to 18 years) diagnosed with ML via abdominal ultrasonography.
- Exclusion criteria included malignancies, acute infections, and current treatments; data analyzed using Mann-Whitney U, chi-square, and Fisher's exact tests.
Main Results:
- ML was most common in children aged 6-11 years, with abdominal pain as the primary symptom (64.2%).
- The majority of ML cases (76.4%) were idiopathic, with infections being common secondary causes.
- Lymph node regression occurred in 71.7% within one month, unaffected by antibiotic use.
Conclusions:
- Pediatric ML is predominantly benign and self-limiting, often resolving without medical intervention.
- Conservative management and careful monitoring are recommended to avoid unnecessary treatments for ML.
- Further research with larger cohorts and longer follow-up is needed to investigate rare causes and long-term outcomes of ML.
Objectives:
This study aimed to evaluate the etiology, clinical characteristics, and outcomes of mesenteric lymphadenopathy (ML) in children, with an emphasis on its clinical significance and management strategies.
Methods:
This cross-sectional, single-center study was conducted between July 2016 and May 2017 and included pediatric patients aged 1 month to 18 years diagnosed with ML via abdominal ultrasonography. Patients with malignancies, acute infections, ongoing corticosteroid or antibiotic treatment, or incomplete follow-up were excluded. Data collection included demographic, clinical, and laboratory findings. Statistical analyses were performed using IBM SPSS Statistics version 25. The Mann-Whitney U test was used for comparisons of numerical variables between groups, while the chi-square and Fisher's exact tests were applied for categorical variables. A p-value less than 0.05 was considered statistically significant.
Results:
A total of 106 patients were included with a median age of 7.4 years (range: 8 months-16.4 years), of whom 55.7% were male. The majority (63%) were aged 6-11 years. Abdominal pain was the most common symptom (64.2%), and 99.1% of the ML cases were localized in the right lower quadrant. At 1-month follow-up, lymph node sizes regressed to normal in 71.7% of cases, while 28.3% remained pathological. Antibiotic use did not significantly affect lymph node regression. At 6 months, no new symptoms or diagnoses were reported in the 91 patients contacted. ML was most often idiopathic (76.4%), with secondary causes including gastrointestinal and respiratory infections, acute abdomen, and Familial Mediterranean Fever.
Conclusion:
In children, ML is predominantly benign and self-limiting, and in most cases, it resolves without medical intervention. Although its association with symptoms such as abdominal pain may cause anxiety in parents, careful monitoring of patients can prevent unnecessary interventions. This study underscored the importance of conservative management and highlighted the need for further research with larger cohorts and extended follow-up periods to explore rare etiologies and long-term outcomes.
