Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case-control study including 1401 patients from Turkey.

Adolescent Adult Aged Aged, 80 and over Case-Control Studies Demography / methods Diagnosis, Differential Female Fever / complications Hepatomegaly / complications Humans Lymph Nodes / pathology Lymphadenopathy / complications Male Middle Aged Retrospective Studies Splenomegaly / complications Tuberculosis / complications Turkey

Etiology LAP Lymphadenopathy Turkey

Journal

Internal and emergency medicine

ISSN: 1970-9366

Titre abrégé: Intern Emerg Med

Pays: Italy

ID NLM: 101263418

Informations de publication

Date de publication:
Nov 2021

Historique:

received: 20 12 2020

accepted: 19 02 2021

pubmed: 18 3 2021

medline: 30 11 2021

entrez: 17 3 2021

Statut: ppublish

Résumé

Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case-control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (n: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (p 0.016, OR 0.386, 95% Cl 0.186-0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (p < 0.001, OR 3.23, 95% Cl 1.99-5.26) and older than 65 years-old (p 0.002, OR 3.36, 95% Cl 1.69-6.68). Age, localization and duration of LAP, leukocytosis, anemia, thrombocytopenia, CRP and sedimentation rate were important parameters to differentiate infections. Size of lymph node and splenomegaly in addition to the parameters above were useful parameters for differentiating malign from benign etiology. Despite the improvements in diagnostic tools, reaching a definite differential diagnosis of lymphadenopathy is still challenging. Our results may help clinicians to decide in which cases they need an aggressive workup and set strategies on optimizing the diagnostic approach of adulthood lymphadenopathy.

Identifiants

DOI: 10.1007/s11739-021-02683-2 PMID: 33728579

pubmed: 33728579

doi: 10.1007/s11739-021-02683-2

pii: 10.1007/s11739-021-02683-2

doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

2139-2153

Informations de copyright

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