Pediatric lymphoid polyps
Introduction
Introduction to Pediatric Lymphoid Polyps Lymphoid polyps, not actually polyps, but localized protrusions of the colonic mucosa, may be a non-specific response to infection due to submucosal lymphoid tissue hyperplasia, and increased lymph node enlargement at the terminal ileum mucosa. In the case of offline barium enema or endoscopy, similar polyps-like changes can be seen, so they are often confused with real polyps. It is a benign and self-limiting disease. basic knowledge Sickness ratio: 0.02%-0.06% Susceptible people: children Mode of infection: non-infectious Complications: anemia
Cause
Pediatric lymphoid polyps
Cause:
It is not clear that it has lymph node-like hyperplasia, and some people think that it is an allergic non-specific reaction to viruses, anti-inflammatory drugs or infections.
Pathogenesis
Lymphoid polyps can occur in any part of the intestine, most commonly at the distal end of the ileum and at the distal end of the colon. Due to lymphoid hyperplasia or lymphocyte accumulation, the intestinal mucosa protrudes into a nodular shape, with nodules on average 1 to 5 mm in diameter. In the central protrusion, because the ulcer can be sunken, the X-ray gas double enema angiography shows uniformity, and the central depression is filled with the shadow of the tincture, which is the most reliable diagnostic method. This can be distinguished from juvenile polyps and multiple adenomatoid polyps. Histological examination confirmed that the intestinal mucosa was normal, the submucosal lymph nodes and enlarged lymphoid follicles were prominent, and sigmoidoscopy or fiberoptic colonoscopy showed small uneven protrusions on the normal intestinal mucosa, and some had ulcers at the apex. There is no pedicle formation, causing gastrointestinal bleeding due to ulcers.
Prevention
Pediatric lymphoid polyps prevention
The prevention method is the same as diarrhea in children. Because the disease is currently thought to be related to viruses, bacterial infections, and allergic reactions to anti-inflammatory drugs, it is necessary to actively prevent various infectious diseases of the digestive tract. WHO recommends the following measures to prevent children's digestive tract infections. Sexual diseases, that is, breastfeeding, combined with the experience of prevention and treatment of infectious diseases in the digestive tract in China for many years, aiming at the current prevention and treatment, clearly stipulate the following measures for the prevention of infectious diseases of the digestive tract, that is, to improve the purity of infants within 4 months. Breastfeeding rate; improve personal hygiene habits; wash hands before and after meals; properly handle children's feces; use sufficient clean water; harmless treatment of feces; apply safe and hygienic methods to prepare household foods, especially to add food supplements reasonably and hygienically Strengthening the hygiene management and supervision in the process of food production, transportation and sales, and earnestly achieving the above points, it will effectively prevent various infectious diseases of the digestive tract.
Complication
Pediatric lymphoid polyp complications Complications anemia
Concurrent small cell hypochromic anemia.
Small cell hypochromic anemia refers to the low hemoglobin in your red blood cells, so it has low pigmentation and small cell volume, so it is called small cell.
Most of this anemia is caused by iron deficiency, so it is necessary to eliminate the cause and supplement the iron.
Small cell hypochromic anemia mainly includes:
(1) Iron deficiency anemia: refers to anemia in which the storage of iron in the body is exhausted and the maturation of red blood cells is affected.
(2) globin-producing anemia: mainly heavy beta thalassemia, mild beta thalassemia, HbH disease. They often have a family history.
(3) iron granulocyte anemia: including a variety of causes of hypopigmentation anemia. Hemoglobin synthesis disorders and poor iron utilization, accompanied by the ineffective formation of red blood cells is a common mechanism for the occurrence of such anemia.
(4) Transferrin deficiency: also known as no transferrinemia, refers to the lack or lack of transferrin in the plasma of patients due to genetic defects. There is a large amount of iron in the liver, spleen, and pancreas, and no iron is available in the bone marrow to synthesize hemoglobin. This disease is very rare.
(5) Primary pulmonary hemosiderosis and pulmonary and renal hemorrhagic syndrome: Primary pulmonary hemosiderosis is a rare iron metabolism disorder characterized by extensive pulmonary capillary hemorrhage. There is a large amount of hemosiderin in the alveoli, accompanied by iron deficiency anemia.
(6) Chronic infectious anemia and other: chronic infectious anemia, although the serum iron is reduced, but the total iron binding capacity will not increase or decrease, so the transferrin saturation is normal or slightly increased. Serum ferritin is often elevated. The number of iron granulocytes in the bone marrow decreased, and the hemosiderin particles increased significantly. Others such as lead poisoning can cause small cell hypochromic anemia.
Symptom
Pediatric lymphoid polyps symptoms Common symptoms Polyposis blood in the stool
The main symptoms are chronic hemorrhagic anemia, occasional abdominal pain, fecal occult blood test positive, individual patients can have acute massive bloody stools, some patients can be asymptomatic and found at the time of examination, feasible X-ray barium meal, barium enema and biopsy to confirm the diagnosis, It is necessary to distinguish leukemia from the intestinal wall (peripheral blood and bone marrow abnormalities) and familial polyposis.
Examine
Pediatric lymphoid polyps
Laboratory examination of peripheral blood can be found to reduce hemoglobin and red blood cell count; stool routine examination of fecal occult blood positive, other tests are normal.
1. X-ray barium meal, double gastroenterology enema: showing uniform filling defects and central depression filled with tincture, is the most reliable diagnostic method, which is different from juvenile polyps and multiple adenomatous polyposis.
2. Endoscopy: Sigmoidoscopy or fiberoptic colonoscopy revealed small protrusions with uniform distribution on the normal mucosa, some of which had ulcers and no pedicle formation.
3. Biopsy: normal mucosa, submucosal lymphoid hyperplasia.
Diagnosis
Diagnosis and diagnosis of lymphoid polyps in children
According to clinical features and auxiliary examination confirmed.
1. Leukemia: Intestinal wall invasion of other manifestations of leukemia, such as anemia, bleeding, infection, hepatosplenomegaly, and peripheral blood visible immature cells.
2. Other: Another attention should be paid to the identification of familial polyps and multiple adenomatoid tumor polyps.
