title: Intestinal lymphonodular hyperplasia of childhood: patterns of presentation.
abstract: In this retrospective analysis we searched for a constellation of signs or symptoms attributable to childhood lymphonodular hyperplasia (LNH). Of 147 children with documented LNH reviewed, 43% had lesions in the small bowel, and 57% in the large bowel. Children in this study presented with complaints of abdominal pain (58%) and bright red blood per rectum (32%). Physical examination revealed little except right lower quadrant (RLQ) abdominal tenderness and "fullness" in 35%. The pain was periumbilical, dull-cramping, rarely acute, and nonradiating. The hematochezia was most commonly streaky red in mucoid strands adhering to the stools, with no associated tenesmus. Three clinical patterns emerged: (a) Under 1 year of age most patients were male, with painless bleeding and pancolonic LNH. (b) Between 2 and 6 years, although the LNH was predominantly colonic, pain and bleeding occurred equally. (c) From 7 years old on, the main symptom was abdominal pain, but LNH distribution was nearly equal between the small bowel and the colon. To date, our long-term follow-up of the children with isolated LNH has revealed no sequelae.
authors.affiliation: Department of Pediatrics, Georgetown University School of Medicine, Washington, D.C. 20007.
authors.forename: A R
authors.initials: AR
authors.lastname: Colón
authors.forename: J S
authors.initials: JS
authors.lastname: DiPalma
authors.forename: C A
authors.initials: CA
authors.lastname: Leftridge
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D002648:Child; D003106:Colon / Q000473:pathology; D003108:Colonic Diseases / Q000150:complications* / Q000473:pathology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D006965:Hyperplasia; D007077:Ileal Diseases / Q000150:complications* / Q000473:pathology; D007082:Ileum / Q000473:pathology; D008206:Lymphatic Diseases / Q000150:complications* / Q000473:pathology; D008221:Lymphoid Tissue / Q000473:pathology*; D008297:Male; D012007:Rectum