Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey
Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested cas...
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| Veröffentlicht in: | Internal and emergency medicine 2021-11, Vol.16 (8), p.2139-2153 |
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| creator | Yenilmez, Ercan Verdi, Yıldız Ilbak, Ayca Demirkiran, Burcu Caliskan Duman, Zehra Bozkurt, Fatma Seyman, Derya Asan, Ali Eker, Halime Betul Sahin Ceylan, Mehmet Resat Emre, Salih Altunyurt, Gozde Ozturk Ayan, Saliha Parlak, Emine Toros, Goknur Yapar Yoruk, Gulsen Ceylan, Mehmet Karaagac, Leman Ozguler, Muge Meral, Busra Ay, Muzeyyen Ozturk, Cinar Karacaer, Zehra Tural, Ersin Cetinkaya, Rıza Aytac Dokmetas, Ilyas Kose, Sukran |
| description | Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case–control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (
n
: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (
p
0.016, OR 0.386, 95% Cl 0.186–0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (
p
|
| doi_str_mv | 10.1007/s11739-021-02683-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2502203758</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2502203758</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-bd2012700def4809629c8f30bd427a17e3fdc51af11ba5ce8055a0ac790d9ac13</originalsourceid><addsrcrecordid>eNp9ks1u1TAQhSMEoqXwAiyQJTZFasB2bq4TdVWVX6kSLMo6mtiTGxfHDrazyI534A15BV6Aub0FJBYsLI_G3zkzsk5RPBX8peBcvUpCqKotuRR0tk1VynvFsWgVL9tqu71PdSObkm826qh4lNIN53W9FephcVRVSja1ao-Ln69xCrsI82j1GdPOeqvBMfCGOehDhBziyvQIEXTGaFO2OrEhRGbsMGBEny3xxsLOh2QTCwObiZtHjNR36zSPYNCHGfK4stOri08vbt3ziAyzDS7srCZ9ytH2CzX83oIwZj0Ds7iczhmwiQqraRrGM-YxZTRMQ8If377r4HMMjqW8mJVU2i3G-h0TGy4YjbWkopVjmNj1Er_g-rh4MIBL-OTuPik-v31zffm-vPr47sPlxVWpK1XnsjeSC6k4NzhsGt5uZauboeK92UgFQmE1GF0LGIToodbY0PcCB61ablrQojopTg--cwxfF9q5m2zS6Bx4DEvqZM2l5DSrIfT5P-hNWKKn7YhqRUNMs6fkgdIxpBRx6OZoJ4hrJ3i3j0R3iERHkehuI9FJEj27s176Cc0fye8MEFAdgERPfofx7-z_2P4C0y3IKQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2591875888</pqid></control><display><type>article</type><title>Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey</title><source>SpringerLink Journals</source><creator>Yenilmez, Ercan ; Verdi, Yıldız ; Ilbak, Ayca ; Demirkiran, Burcu Caliskan ; Duman, Zehra ; Bozkurt, Fatma ; Seyman, Derya ; Asan, Ali ; Eker, Halime Betul Sahin ; Ceylan, Mehmet Resat ; Emre, Salih ; Altunyurt, Gozde Ozturk ; Ayan, Saliha ; Parlak, Emine ; Toros, Goknur Yapar ; Yoruk, Gulsen ; Ceylan, Mehmet ; Karaagac, Leman ; Ozguler, Muge ; Meral, Busra ; Ay, Muzeyyen ; Ozturk, Cinar ; Karacaer, Zehra ; Tural, Ersin ; Cetinkaya, Rıza Aytac ; Dokmetas, Ilyas ; Kose, Sukran</creator><creatorcontrib>Yenilmez, Ercan ; Verdi, Yıldız ; Ilbak, Ayca ; Demirkiran, Burcu Caliskan ; Duman, Zehra ; Bozkurt, Fatma ; Seyman, Derya ; Asan, Ali ; Eker, Halime Betul Sahin ; Ceylan, Mehmet Resat ; Emre, Salih ; Altunyurt, Gozde Ozturk ; Ayan, Saliha ; Parlak, Emine ; Toros, Goknur Yapar ; Yoruk, Gulsen ; Ceylan, Mehmet ; Karaagac, Leman ; Ozguler, Muge ; Meral, Busra ; Ay, Muzeyyen ; Ozturk, Cinar ; Karacaer, Zehra ; Tural, Ersin ; Cetinkaya, Rıza Aytac ; Dokmetas, Ilyas ; Kose, Sukran</creatorcontrib><description>Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case–control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (
n
: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (
p
0.016, OR 0.386, 95% Cl 0.186–0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (
p
< 0.001, OR 3.23, 95% Cl 1.99–5.26) and older than 65 years-old (
p
0.002, OR 3.36, 95% Cl 1.69–6.68). Age, localization and duration of LAP, leukocytosis, anemia, thrombocytopenia, CRP and sedimentation rate were important parameters to differentiate infections. Size of lymph node and splenomegaly in addition to the parameters above were useful parameters for differentiating malign from benign etiology. Despite the improvements in diagnostic tools, reaching a definite differential diagnosis of lymphadenopathy is still challenging. Our results may help clinicians to decide in which cases they need an aggressive workup and set strategies on optimizing the diagnostic approach of adulthood lymphadenopathy.</description><identifier>ISSN: 1828-0447</identifier><identifier>EISSN: 1970-9366</identifier><identifier>DOI: 10.1007/s11739-021-02683-2</identifier><identifier>PMID: 33728579</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Differential diagnosis ; Etiology ; Im - Original ; Inflammatory diseases ; Internal Medicine ; Laboratories ; Leukocytosis ; Localization ; Lymph nodes ; Lymphadenopathy ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Patients ; Splenomegaly ; Thrombocytopenia ; Tuberculosis</subject><ispartof>Internal and emergency medicine, 2021-11, Vol.16 (8), p.2139-2153</ispartof><rights>Società Italiana di Medicina Interna (SIMI) 2021</rights><rights>Società Italiana di Medicina Interna (SIMI) 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-bd2012700def4809629c8f30bd427a17e3fdc51af11ba5ce8055a0ac790d9ac13</citedby><cites>FETCH-LOGICAL-c375t-bd2012700def4809629c8f30bd427a17e3fdc51af11ba5ce8055a0ac790d9ac13</cites><orcidid>0000-0002-1145-8856</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11739-021-02683-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11739-021-02683-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33728579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yenilmez, Ercan</creatorcontrib><creatorcontrib>Verdi, Yıldız</creatorcontrib><creatorcontrib>Ilbak, Ayca</creatorcontrib><creatorcontrib>Demirkiran, Burcu Caliskan</creatorcontrib><creatorcontrib>Duman, Zehra</creatorcontrib><creatorcontrib>Bozkurt, Fatma</creatorcontrib><creatorcontrib>Seyman, Derya</creatorcontrib><creatorcontrib>Asan, Ali</creatorcontrib><creatorcontrib>Eker, Halime Betul Sahin</creatorcontrib><creatorcontrib>Ceylan, Mehmet Resat</creatorcontrib><creatorcontrib>Emre, Salih</creatorcontrib><creatorcontrib>Altunyurt, Gozde Ozturk</creatorcontrib><creatorcontrib>Ayan, Saliha</creatorcontrib><creatorcontrib>Parlak, Emine</creatorcontrib><creatorcontrib>Toros, Goknur Yapar</creatorcontrib><creatorcontrib>Yoruk, Gulsen</creatorcontrib><creatorcontrib>Ceylan, Mehmet</creatorcontrib><creatorcontrib>Karaagac, Leman</creatorcontrib><creatorcontrib>Ozguler, Muge</creatorcontrib><creatorcontrib>Meral, Busra</creatorcontrib><creatorcontrib>Ay, Muzeyyen</creatorcontrib><creatorcontrib>Ozturk, Cinar</creatorcontrib><creatorcontrib>Karacaer, Zehra</creatorcontrib><creatorcontrib>Tural, Ersin</creatorcontrib><creatorcontrib>Cetinkaya, Rıza Aytac</creatorcontrib><creatorcontrib>Dokmetas, Ilyas</creatorcontrib><creatorcontrib>Kose, Sukran</creatorcontrib><title>Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey</title><title>Internal and emergency medicine</title><addtitle>Intern Emerg Med</addtitle><addtitle>Intern Emerg Med</addtitle><description>Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case–control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (
n
: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (
p
0.016, OR 0.386, 95% Cl 0.186–0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (
p
< 0.001, OR 3.23, 95% Cl 1.99–5.26) and older than 65 years-old (
p
0.002, OR 3.36, 95% Cl 1.69–6.68). Age, localization and duration of LAP, leukocytosis, anemia, thrombocytopenia, CRP and sedimentation rate were important parameters to differentiate infections. Size of lymph node and splenomegaly in addition to the parameters above were useful parameters for differentiating malign from benign etiology. Despite the improvements in diagnostic tools, reaching a definite differential diagnosis of lymphadenopathy is still challenging. Our results may help clinicians to decide in which cases they need an aggressive workup and set strategies on optimizing the diagnostic approach of adulthood lymphadenopathy.</description><subject>Differential diagnosis</subject><subject>Etiology</subject><subject>Im - Original</subject><subject>Inflammatory diseases</subject><subject>Internal Medicine</subject><subject>Laboratories</subject><subject>Leukocytosis</subject><subject>Localization</subject><subject>Lymph nodes</subject><subject>Lymphadenopathy</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patients</subject><subject>Splenomegaly</subject><subject>Thrombocytopenia</subject><subject>Tuberculosis</subject><issn>1828-0447</issn><issn>1970-9366</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9ks1u1TAQhSMEoqXwAiyQJTZFasB2bq4TdVWVX6kSLMo6mtiTGxfHDrazyI534A15BV6Aub0FJBYsLI_G3zkzsk5RPBX8peBcvUpCqKotuRR0tk1VynvFsWgVL9tqu71PdSObkm826qh4lNIN53W9FephcVRVSja1ao-Ln69xCrsI82j1GdPOeqvBMfCGOehDhBziyvQIEXTGaFO2OrEhRGbsMGBEny3xxsLOh2QTCwObiZtHjNR36zSPYNCHGfK4stOri08vbt3ziAyzDS7srCZ9ytH2CzX83oIwZj0Ds7iczhmwiQqraRrGM-YxZTRMQ8If377r4HMMjqW8mJVU2i3G-h0TGy4YjbWkopVjmNj1Er_g-rh4MIBL-OTuPik-v31zffm-vPr47sPlxVWpK1XnsjeSC6k4NzhsGt5uZauboeK92UgFQmE1GF0LGIToodbY0PcCB61ablrQojopTg--cwxfF9q5m2zS6Bx4DEvqZM2l5DSrIfT5P-hNWKKn7YhqRUNMs6fkgdIxpBRx6OZoJ4hrJ3i3j0R3iERHkehuI9FJEj27s176Cc0fye8MEFAdgERPfofx7-z_2P4C0y3IKQ</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Yenilmez, Ercan</creator><creator>Verdi, Yıldız</creator><creator>Ilbak, Ayca</creator><creator>Demirkiran, Burcu Caliskan</creator><creator>Duman, Zehra</creator><creator>Bozkurt, Fatma</creator><creator>Seyman, Derya</creator><creator>Asan, Ali</creator><creator>Eker, Halime Betul Sahin</creator><creator>Ceylan, Mehmet Resat</creator><creator>Emre, Salih</creator><creator>Altunyurt, Gozde Ozturk</creator><creator>Ayan, Saliha</creator><creator>Parlak, Emine</creator><creator>Toros, Goknur Yapar</creator><creator>Yoruk, Gulsen</creator><creator>Ceylan, Mehmet</creator><creator>Karaagac, Leman</creator><creator>Ozguler, Muge</creator><creator>Meral, Busra</creator><creator>Ay, Muzeyyen</creator><creator>Ozturk, Cinar</creator><creator>Karacaer, Zehra</creator><creator>Tural, Ersin</creator><creator>Cetinkaya, Rıza Aytac</creator><creator>Dokmetas, Ilyas</creator><creator>Kose, Sukran</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1145-8856</orcidid></search><sort><creationdate>20211101</creationdate><title>Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey</title><author>Yenilmez, Ercan ; Verdi, Yıldız ; Ilbak, Ayca ; Demirkiran, Burcu Caliskan ; Duman, Zehra ; Bozkurt, Fatma ; Seyman, Derya ; Asan, Ali ; Eker, Halime Betul Sahin ; Ceylan, Mehmet Resat ; Emre, Salih ; Altunyurt, Gozde Ozturk ; Ayan, Saliha ; Parlak, Emine ; Toros, Goknur Yapar ; Yoruk, Gulsen ; Ceylan, Mehmet ; Karaagac, Leman ; Ozguler, Muge ; Meral, Busra ; Ay, Muzeyyen ; Ozturk, Cinar ; Karacaer, Zehra ; Tural, Ersin ; Cetinkaya, Rıza Aytac ; Dokmetas, Ilyas ; Kose, Sukran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-bd2012700def4809629c8f30bd427a17e3fdc51af11ba5ce8055a0ac790d9ac13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Differential diagnosis</topic><topic>Etiology</topic><topic>Im - Original</topic><topic>Inflammatory diseases</topic><topic>Internal Medicine</topic><topic>Laboratories</topic><topic>Leukocytosis</topic><topic>Localization</topic><topic>Lymph nodes</topic><topic>Lymphadenopathy</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patients</topic><topic>Splenomegaly</topic><topic>Thrombocytopenia</topic><topic>Tuberculosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yenilmez, Ercan</creatorcontrib><creatorcontrib>Verdi, Yıldız</creatorcontrib><creatorcontrib>Ilbak, Ayca</creatorcontrib><creatorcontrib>Demirkiran, Burcu Caliskan</creatorcontrib><creatorcontrib>Duman, Zehra</creatorcontrib><creatorcontrib>Bozkurt, Fatma</creatorcontrib><creatorcontrib>Seyman, Derya</creatorcontrib><creatorcontrib>Asan, Ali</creatorcontrib><creatorcontrib>Eker, Halime Betul Sahin</creatorcontrib><creatorcontrib>Ceylan, Mehmet Resat</creatorcontrib><creatorcontrib>Emre, Salih</creatorcontrib><creatorcontrib>Altunyurt, Gozde Ozturk</creatorcontrib><creatorcontrib>Ayan, Saliha</creatorcontrib><creatorcontrib>Parlak, Emine</creatorcontrib><creatorcontrib>Toros, Goknur Yapar</creatorcontrib><creatorcontrib>Yoruk, Gulsen</creatorcontrib><creatorcontrib>Ceylan, Mehmet</creatorcontrib><creatorcontrib>Karaagac, Leman</creatorcontrib><creatorcontrib>Ozguler, Muge</creatorcontrib><creatorcontrib>Meral, Busra</creatorcontrib><creatorcontrib>Ay, Muzeyyen</creatorcontrib><creatorcontrib>Ozturk, Cinar</creatorcontrib><creatorcontrib>Karacaer, Zehra</creatorcontrib><creatorcontrib>Tural, Ersin</creatorcontrib><creatorcontrib>Cetinkaya, Rıza Aytac</creatorcontrib><creatorcontrib>Dokmetas, Ilyas</creatorcontrib><creatorcontrib>Kose, Sukran</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Internal and emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yenilmez, Ercan</au><au>Verdi, Yıldız</au><au>Ilbak, Ayca</au><au>Demirkiran, Burcu Caliskan</au><au>Duman, Zehra</au><au>Bozkurt, Fatma</au><au>Seyman, Derya</au><au>Asan, Ali</au><au>Eker, Halime Betul Sahin</au><au>Ceylan, Mehmet Resat</au><au>Emre, Salih</au><au>Altunyurt, Gozde Ozturk</au><au>Ayan, Saliha</au><au>Parlak, Emine</au><au>Toros, Goknur Yapar</au><au>Yoruk, Gulsen</au><au>Ceylan, Mehmet</au><au>Karaagac, Leman</au><au>Ozguler, Muge</au><au>Meral, Busra</au><au>Ay, Muzeyyen</au><au>Ozturk, Cinar</au><au>Karacaer, Zehra</au><au>Tural, Ersin</au><au>Cetinkaya, Rıza Aytac</au><au>Dokmetas, Ilyas</au><au>Kose, Sukran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey</atitle><jtitle>Internal and emergency medicine</jtitle><stitle>Intern Emerg Med</stitle><addtitle>Intern Emerg Med</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>16</volume><issue>8</issue><spage>2139</spage><epage>2153</epage><pages>2139-2153</pages><issn>1828-0447</issn><eissn>1970-9366</eissn><abstract>Peripheral lymphadenopathy (LAP) is an important and common abnormal finding of the physical exam in general medical practice. We aimed to reveal the LAP etiology and demographic, clinical and laboratory variables that may be useful in the differential evaluation of LAP. This multicenter, nested case–control study including 1401 patients between 2014 and 2019 was conducted in 19 tertiary teaching and research hospitals from different regions in Turkey. The ratio of infectious, malign and autoimmune/inflammatory diseases was 31.3%, 5% and 0.3%, respectively. In 870 (62%) of patients had nonspecific etiology. Extrapulmonary tuberculosis (
n
: 235, 16.8%) was the most frequent cause of LAP. The ratio of infective etiology of LAP was significantly lower in patients older than 65 years-old compared to younger patients with the rate of 66.67% and 83.84%, respectively (
p
0.016, OR 0.386, 95% Cl 0.186–0.803). The probability of malign etiology was higher both in patients who are older than 45 years-old (
p
< 0.001, OR 3.23, 95% Cl 1.99–5.26) and older than 65 years-old (
p
0.002, OR 3.36, 95% Cl 1.69–6.68). Age, localization and duration of LAP, leukocytosis, anemia, thrombocytopenia, CRP and sedimentation rate were important parameters to differentiate infections. Size of lymph node and splenomegaly in addition to the parameters above were useful parameters for differentiating malign from benign etiology. Despite the improvements in diagnostic tools, reaching a definite differential diagnosis of lymphadenopathy is still challenging. Our results may help clinicians to decide in which cases they need an aggressive workup and set strategies on optimizing the diagnostic approach of adulthood lymphadenopathy.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33728579</pmid><doi>10.1007/s11739-021-02683-2</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-1145-8856</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1828-0447 |
| ispartof | Internal and emergency medicine, 2021-11, Vol.16 (8), p.2139-2153 |
| issn | 1828-0447 1970-9366 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2502203758 |
| source | SpringerLink Journals |
| subjects | Differential diagnosis Etiology Im - Original Inflammatory diseases Internal Medicine Laboratories Leukocytosis Localization Lymph nodes Lymphadenopathy Medical diagnosis Medicine Medicine & Public Health Patients Splenomegaly Thrombocytopenia Tuberculosis |
| title | Demographic, clinical and laboratory characteristics for differential diagnosis of peripheral lymphadenopathy (LAP) and the etiologic distribution of LAP in adults; a multicenter, nested case–control study including 1401 patients from Turkey |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T04%3A59%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Demographic,%20clinical%20and%20laboratory%20characteristics%20for%20differential%20diagnosis%20of%20peripheral%20lymphadenopathy%20(LAP)%20and%20the%20etiologic%20distribution%20of%20LAP%20in%20adults;%20a%20multicenter,%20nested%20case%E2%80%93control%20study%20including%201401%20patients%20from%20Turkey&rft.jtitle=Internal%20and%20emergency%20medicine&rft.au=Yenilmez,%20Ercan&rft.date=2021-11-01&rft.volume=16&rft.issue=8&rft.spage=2139&rft.epage=2153&rft.pages=2139-2153&rft.issn=1828-0447&rft.eissn=1970-9366&rft_id=info:doi/10.1007/s11739-021-02683-2&rft_dat=%3Cproquest_cross%3E2502203758%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2591875888&rft_id=info:pmid/33728579&rfr_iscdi=true |