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Pathophysiology and Pharmacology

Detailed Underlying Pathophysiology

According to Werbel, Castrovinci and Contestable (2019), the symptoms of lymphadenopathy includes a swollen spleen and liver, sore throat, runny nose, fever, unexplained weight loss, a low respiratory rate which affect blood pressure, upper respiratory infection, more tiredness than usual, body aches, poor appetite, painful or red bruises or a lump under the skin, excessive sweating, and fatigue.

According to Abuelgasim, Salih and Al Jesh et al. (2019), the disease is contracted by blood cancers like lymphoma, leukemia, or infection from bacteria, virus, or fungus like the common cold, tuberculosis, strep throat, infected tooth, skin or wound infection, ear infection, measles, adenopathy or others. In this case study, the child had a physical examination showing adenopathy, family history of infection, missed bout of measles, and the other infections can lead to swelling of lymph nodes.

According to Coughlin and Mukerji (2019), the pathophysiology of the disease includes – due to infections as the immune system of the body gets activated and a result a large number of macrophages and normal lymphocytes are produced in response to the antigen. This further leads to nodal infiltration due to infection in the nodes by the inflammatory cells. This leads to a condition called lymphadenitis. Then, there is proliferation if a large number of macrophages and normal lymphocytes (lymphoma). The foreign antigens are stored in the nodes leading to edema and cytokine release. All these factors lead to swelling of lymph of chest nodes leading to low respiratory rate, bruises under the skin, enlarged spleen might compress the stomach and affect appetite, and sweating is produced due to the production of immune cells in response to infection.

According to Firwana, Ravilla and Raval et al. (2017), it is found that every year 30 to 40 children are diagnosed with lymphoma in Australia. There is a 0.6 % of the occurrence of this health condition annually in Australia. More than 80 % of children suffer from an ear infection. Many in Australia also suffer from tuberculosis (1300 every year), HIV/AIDS (973 cases in 2019), and many others. All these infections and conditions lead to a contribution to lymphadenopathy. 

According to Gong, Yang and Yan et al. (2018), the risk factors include – males are more prone to the condition than females, whites are more prone than Asians, environmental factors, alcohol, drugs, duration of breastfeeding, immunization, antimicrobial drug therapy, and few others. All these factors are modifiable and non-modifiable as well. Like the vaccination status is non-modifiable as they are administered at a particular time at particular stages and if not administered then it can affect the body. The modifiable factors like smoking environment, parent education, and a few others can be improved. These can be resolved by medications like antibiotics, anti-inflammatory drugs, or a few others depending upon the cause (Raskin, Khaitovich and Balan et al. 2020).

Conclusion on The Causes of Lymphadenopathy

In this case study, the child is 5 years old who has lymphadenopathy that has affected its body with symptoms like bruises on the skin, low respiratory rate, swollen lymph nodes, fever, and few others. These factors are also diagnosed during the physical examination as well. The treatment also depends upon the cause of the health condition. Like antibiotic drugs for the infection treatment or anti-inflammatory drugs for the treatment of swelling or redness. Moreover, pain-killers can also be used for pain relief. There should be scheduled vaccination administrations as well.

References for The Causes of Lymphadenopathy

Abuelgasim, K.A., Salih, N.H., Al Jesh, S.M., Al-Kaiyat, M.O. and Alshieban, S.S. 2019. The causes of lymphadenopathy: A clinicopathological analysis of 475 cases. International Journal of Clinical and Experimental Pathology, vol. 12, no. 8, pp.3102. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949728/

Coughlin, A. and Mukerji, S.S. 2019. Pediatric cervical lymphadenopathy. Grand Rounds Presentation, The University of Texas Medical Branch, Department of Otolaryngology. https://www.researchgate.net/profile/Andrew_Coughlin/publication/267551437_Pediatric_Cervical_Lymphadenopathy/links/54ed3b4e0cf28f3e65358190.pdf

Firwana, B., Ravilla, R., Raval, M., Hutchins, L. and Mahmoud, F. 2017. Sarcoidosis-like syndrome and lymphadenopathy due to checkpoint inhibitors. Journal of Oncology Pharmacy Practice, vol. 23, no.8, pp.620-624. https://doi.org/10.1177%2F1078155216667635

Gong, Y., Yang, J., Yan, S. and Su, A. 2018. Pattern of and clinicopathologic risk factors for lateral lymph node metastases in papillary thyroid carcinoma patients with lateral cervical lymphadenopathy. Medicine, vol. 97, no. 36. https://dx.doi.org/10.1097%2FMD.0000000000012263

Raskin, D., Khaitovich, B., Balan, S., Silverberg, D., Rmeileh, A.A., Halak, M. and Rimon, U. 2020. Inguinal lymphadenopathy as a predicting factor for ipsilateral primary limb amputation after a successful endovascular treatment. European Journal of Radiology, vol. 130, pp.109162. https://doi.org/10.1016/j.ejrad.2020.109162

Werbel, T., Castrovinci, P. and Contestable, J. 2019. Ethosuximide‐induced drug reaction with eosinophilia and systemic symptoms with mediastinal lymphadenopathy. Pediatric Dermatology, vol. 36, no. 4, pp.e99-e101. https://doi.org/10.1111/pde.13848

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