Clinical analysis of 252 children with Epstein-Barr virus infection / 中国基层医药

Objective:To investigate the clinical manifestations of Epstein-Barr virus infection in children and the efficacy of interferon combined with ganciclovir.Methods:A total of 252 children with Epstein-Barr virus infection who received treatment in Liaocheng Maternal and Child Health Hospital from June 2018 to February 2020 were included in this study. They were randomly assigned to undergo treatment either with ganciclovir alone (control group, n = 126) or interferon combined with ganciclovir (experimental group, n = 126). General condition, clinical manifestation, clinical outcomes, and clinical efficacy were compared between the two groups. Results:The 252 children with Epstein-Barr virus infection were divided into four groups according to different age brackets: infancy (3.97%), early childhood (53.57%), preschool (28.97%), school age (13.49%). Children at the early childhood and preschool ages accounted for high proportions. Their clinical manifestations included fever, pharyngeal congestion, cervical lymph node swelling, and pharyngeal pain. Children with hepatosplenomegaly accounted for the highest proportion (44.12%) among those at the school age, and children with binocular edema accounted for the highest proportion (10.37%) among those at the early childhood age. The time to defervesce, eyelid edema, and lymph node regression in the experimental group were (3.55 ± 1.58) hours, (3.82 ± 1.17) hours, and (9.55 ± 1.60) hours respectively, which were significantly shorter than those in the control group [(4.40 ± 1.80) hours, (5.33 ± 1.58) hours, (10.44 ± 1.66) hours, t = 3.64, 2.47, 2.67, P < 0.001, P = 0.024, 0.009]. The total response rate was significantly higher in the experimental group than in the control group [96.03% (107/126) vs. 84.92% (121/126), χ2 = 9.03, P = 0.003]. Conclusion:Epstein-Barr virus infection has different clinical manifestations in children at different ages. Interferon combined with ganciclovir is more effective on Epstein-Barr virus infection than ganciclovir alone.

Surgical peripheral lymph node biopsies in Makurdi, Nigeria

This study aims at determining the diagnostic value of peripheral lymph node biopsy and com-mon causes of lymph node enlargement from biopsies obtained from patients with lymph-node enlargement at different sites in a teaching hospital in north central Nigeria town of Makurdi, Benue State. This is a retrospective study of surgical peripheral lymph node biopsies received in the department of Anatomic Pathology, Benue State University Teaching Hospital, Makurdi, Ni-geria from February, 2012 to September, 2019. Total number of lymph node biopsies during the period was 47 representing 1.0% of surgical pathology specimens submitted to the department; 25 cases were females and 22 were males. Metastatic nodal involvement (57%), lymphoma (23%) and tuberculosis lymphadenitis (11%) were the most common causes of lymph node enlargement. All the studied nodes were localized. The most common sites of lymphadenopathy were axillary (21%), cervical (16%) and Inguinal (6%). While axillary lymph node enlargements were mostly associated with tumor metastasis, cervical and inguinal node enlargements were mostly associated with tuberculosis and lymphoma, respectively. Surgical excision of nodal en-largement for histological examination represents a simple, good diagnostic yield with lack of significant morbidity or mortality.

Changes of intestinal hemodynamics in children with abdominal pain accompanied with or without mesenteric lymph node enlargement / 中国基层医药

Objective To analyze the changes of intestinal hemodynamics in children with abdominal pain accompanied with or without mesenteric lymph node enlargement.Methods From June 2016 to December 2017,in Yuncheng Central Hospital,48 children with abdominal pain and mesenteric lymph node enlargement were randomly selected as the study group,and 49 children with abdominal pain and no mesenteric lymph node swelling were selected as the control group.The end diastolic flow rate,peak systolic flow velocity and resistance index of the SMA were compared by color Doppler ultrasound.Results The end diastolic velocity[(16.46 ± 5.14)cm/s] and peak systolic velocity[(94.89 ±20.15)cm/s]of SMA in the study group were significantly lower than those in the control group [(20.23 ± 6.09) cm/s,(106.98 ± 19.32) cm/s] (t =3.2,3.00,both P ＜ 0.01).There was no statistically significant difference in the SMA resistance index between the two groups [(0.82 ± 0.05) vs.(0.81 ± 0.04)] (t =1.08,P ＞0.05).Conclusion The end diastolic flow rate and peak systolic flow velocity of SMA in children with abdominal pain and mesenteric lymphadenopathy are significantly lower than those with abdominal pain and no mesenteric lymph node enlargement.This shows that the end diastolic flow rate and peak systolic flow velocity of SMA can effectively reflect the changes in the intestinal flow mechanics of the children,which can be used to diagnose the mesenteric drenching in children.It provides a reliable basis for the enlargement of the knot.

Unusual Presentation of Angioimmunoblastic T-cell Lymphoma as a Solitary Lymph Node.

Introduction: Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive subtype of peripheral T-cell lymphoma (PTCL) characterized by systemic disease. It is a rare subtype of non-Hodgkin’s lymphomas. However, it forms a major subset of PTCL. Lymph node is the primary site of disease and virtually all patients present with generalized lymphadenopathy. Case report: A 42-year-old male presented with fever of short duration and a solitary axillary lymph node swelling on the right side. Systemic examination revealed moderate ascites and hepatosplenomegaly. Hematological investigations showed pancytopenia and abnormal liver function. Axillary lymph node showed histological features suggesting AITL and was confirmed by a panel of immunohistochemistry (IHC). Conclusion: AITL presenting as solitary axillary lymph node enlargement is unusual. Such atypical presentation mandates careful clinical and laboratory evaluation. IHC is an effective ancillary tool for confirmation of diagnosis of this distinct clinicopathological entity.

A case of pelvic actinomyosis presenting as an advanced ovarian malignancy / 대한산부인과학회지

Pelvic actinomycosis is an infrequent chronic suppurative granulomatous disease, caused by a gram-positive bands Actinomyces israelii. It is often reported as a complicated case of an intrauterine device (IUD). Ureteral obstruction and subsequent hydronephrosis are rare complications of pelvic inflammatory disease. Sometimes pelvic actinomyosis is simulating ovarian malignancy. We report a case combined with hydronephrosis, multiple pelvic lymph nodes enlargements and elevated CA 125 as complications of pelvic actinomycosis.

A case of pelvic actinomyosis presenting as an advanced ovarian malignancy / 대한산부인과학회지

Pelvic actinomycosis is an infrequent chronic suppurative granulomatous disease, caused by a gram-positive bands Actinomyces israelii. It is often reported as a complicated case of an intrauterine device (IUD). Ureteral obstruction and subsequent hydronephrosis are rare complications of pelvic inflammatory disease. Sometimes pelvic actinomyosis is simulating ovarian malignancy. We report a case combined with hydronephrosis, multiple pelvic lymph nodes enlargements and elevated CA 125 as complications of pelvic actinomycosis.

Generalized Primary Amyloid Lymphadenopathy

Systemic amyloidosis is a disease that displays deposition of insoluble polymeric protein fibrils in tissues and organs. We report here on a case of a 64-year-old woman who initially presented with multiple enlarged lymph nodes. Computed tomography showed multiple enlarged lymph nodes in the mediastinal, lower cervical, supraclavicular, axillary and abdominal areas. Excision biopsy of the cervical lymph nodes and the subsequent histopathology showed amorphous eosinophilic material deposits, and these revealed apple-green birefringence on a polarizing microscopic examination on the Congo-red stained slide. The patient was diagnosed with amyloidosis and she received chemotherapy consisting of melphalan and dexamethasone. During chemotherapy, she was diagnosed with breast cancer. After modified unilateral radical mastectomy, the dexamethasone was restarted and this therapy resulted in stable disease.

Immune reconstitution syndrome in patients treated for HIV and tuberculosis in Rio de Janeiro

We made a retrospective longitudinal study from January 2000 to January 2003 to examine cases of immune reconstitution syndrome (IRS) and its incidence rate in tuberculosis (TB)-human immunodeficiency virus (HIV) co-infected patients. The incidence rate (IR) was calculated using a Poisson regression. The confidence interval (CI) that was stipulated was 95 percent. IRS occurred in 10/84 HIV and TB-positive patients; nine of them were on highly active anti-retroviral therapy (HAART) during a mean of 61.7 (±59) days following the introduction of antiretrovirals. Lymph-node enlargement was the sole clinical manifestation. CD4 counts were <100 cells/mm³in 50 percent of the patients, at the time of TB diagnosis. All but two patients were treated with prednisone, and recovered from TB within a mean of 91 days (±30 days). One relapse of TB was observed, but there were no IRS-related deaths. The incidence rate was higher (IR=11.18; CI, 1.41-88.76) in patients that had superficial lymph node enlargement at the moment of TB diagnosis (not associated with TB), extrapulmonary TB (IR=1.97; CI, 0.44-8.79), were antiretroviral naive (IR=1.85; CI, 0.48-7.16), and CD4 counts <100 cells/mm³ (IR=1.50; CI, 0.40-5.59), although with a wide CI. IRS was frequent in our sample, occurred more frequently in HIV-naive patients with lymph-node enlargement and extrapulmonary TB. No cases of new pulmonary lesions or worsening of pulmonary infiltrates were observed.