Artículo de revista
Poliadenopatías de origen reumatológico y las claves del diagnóstico diferencial: Análisis de 19 casos
Fecha
2020Registro en:
Rev Med Chile 2020; 148: 320-326
0034-9887
Autor
Erlij, D.
Cuellar, María Carolina
Badilla, Natalia
Barros, Perla
Méndez, Ignacio
Rivera, Angela
Foster, Carolina
Wolff Cecchi, Verónica
Michalland, Susana
Institución
Resumen
Background: The presence of multiple lymphadenopathies can be a diagnostic
challenge. Aim: To describe the clinical, laboratory and imaging characteristics
of 19 patients with lymphadenopathies of rheumatologic origin. Material and
Methods: Review of medical records of 19 patients aged 16 to 72 years (68%) with
lymphadenopathies presumably secondary to a rheumatic disease. Results: Six
patients had systemic lupus erythematosus, six had Sjogren’s disease, three had
sarcoidosis, two had rheumatoid arthritis, one had IgG4 related disease and one
had mixed connective tissue disease. A lymph node biopsy was performed in
11 patients and in eight a lymphoid follicular hyperplasia was found. Systemic
symptoms were reported by 68% of patients. Blood lactate dehydrogenase was
elevated only in cases associated with hemolytic anemia. There was no specific
or predictable localization of the lymphadenopathies in imaging studies, except
in the cases of sarcoidosis. The average size of the lymphadenopathies was 13.5
mm in diameter in short axis and there was no presence of necrosis, calcification,
or conglomerate formation. Only one case presented splenomegaly. All patients
responded favorably to corticosteroids. Conclusions: Lymphadenopathies
associated with rheumatologic diseases can occur in a wide variety of diseases,
especially systemic lupus erythematosus and Sjögren’s disease. The absence of
LDH elevation and splenomegaly and the absence of imaging findings such as
conglomerates can orient to a rheumatologic origin.