Is abdominal lymphadenopathy a critical health issue?

Question

Hi doctor,

My daughter, who is five years old, was detected with abdominal lymphadenopathy. Her ESR level is 62. She is also suffering from constipation and abdominal pain. Her doctor advised blood tests, ultrasound, and endoscopy followed by histopathology. The biopsy report shows chronic duodenitis with mild eosinophilia and mild intraepithelial lymphocytosis. The reports are uploaded for your reference. The doctor prescribed Esomeprazole (1000 mg) once daily for 30 days, Rifaximin 400 mg three times daily for three days, and Polyethylene glycol 3350 for two months. Is there any critical health issue with my child? We have an interpretation that biopsy is related to cancer. Please clarify. We are so much worried about our child's health.

Answer 1

Hi,

Welcome to icliniq.com.

You should not worry. There is no evidence of cancer in the given scenario (attachment removed to protect patient identity). Lymph nodes (LN) in the abdomen are normal structures. The lymph nodes enlarge in the presence of infection and malignancy. Here, LN is not so enlarged. LN enlargement occurs in case of tuberculosis as well as viral infections, but there is no fever, and bowel loops are normal. So, TB is also unlikely. The concern is about her height. She is of short stature with obesity. In this case, we need to rule out celiac disease. The biopsy is also suggestive of the same. I would advise her to get tTG antibody (tissue transglutaminase) and IgA (immunoglobulin A) to rule out celiac disease. It is a must to do. Continue the same medication and revert after you get the reports. Then, we will plan for a diet. Diet is the only treatment for this condition.