Expert Advice -- Swollen Lymph Nodes

I am a father of a 17 month old who was seen recently by the pediatrician and diagnosed with adenitis. We are having some tests done for mononucleosis and are searching for more info on how this might affect a child so young. He has some swelling in his lymph nodes but no other signs of Mono. We had some previous blood work (sedimentation rate), and it came back normal (5). Let me know if you can enlighten me.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Lymph nodes are sort of the "weigh stations" of the immune system. When an illness occurs in the body, the infection is first attacked by the fighting white cells of the body. These white cells then converge at these weigh stations. These nodes essentially keep the invader restricted to a limited area thus allowing for more effective elimination of the infection. This implies that the lymph nodes may swell during any infection whether it be an illness that is limited to one area of the body such as strep throat or one that involves much of the body such as the flu.

Since lymph nodes swell whenever the immune system is activated, their increasing size during an infection should not be viewed with alarm but almost always with comfort since it signifies the body is doing the right thing. But the lymph nodes are funny things because of their role in the immune system. Since they contain white blood cells, anything that tends to activate or cause the number of white blood cells to rise will also tend to cause the lymph nodes to swell. Examples of these could include damage to tissues. Anyone who has gotten a bad burn in the mouth from hot pizza may also have noticed the lymph nodes of the neck enlarge simply due to the immune system activation from the injury. Certain medications can cause transient increases or activation of the immune system. And of course cancer can cause the lymph nodes to grow as well.

Overwhelmingly, the most common cause of increased swelling of lymph nodes in children (adenitis) is a viral infection. And it is not uncommon to contract a viral illness without manifesting much in the way of other symptoms. Most of the time, it is impossible to determine exactly which virus is causing the swelling. Fortunately, it is almost always unnecessary to know that information since the body generally does a great job of eliminating the virus leaving only certain tell-tale signs namely slightly enlarged lymph nodes. It is obviously impossible for me to confidently tell you what is causing your child's adenitis without examining him. But the odds are highly in his favor that the lymph nodes are reacting to a recent infection. I encourage you to seek the reassurance from your pediatrician assuming your child's adenitis is simply a normal event, and certainly her limited blood testing seems to support that. If, however, other concerns are being entertained by the doctor, be sure to keep an ongoing dialogue going with him as the lymph node swelling may be persistent for many weeks.

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