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Swollen lymph nodes in groin - child
(I have cross posted this in pediatrics)
A couple months ago we took our son (7) to his GP about the fact that he seemed to be leaking urine, not large amounts, but enough that you can smell it on him in the morning, sometimes at the end of the day. They did a urinalysis etc... and all was clear. We went back for follow up a month ago, and he did a physical exam, and noted that my son's lymph nodes in the groin area were a bit enlarged. At the time he decided to repeat the urinalysis, to check again for infection, and noted that if there was an infection (especially down there), that it could cause some swelling of the lymph nodes, which would go away within a couple weeks. He wanted to see us back in four weeks to check on the lymph nodes. (The urinalysis was again clear). So we went back yesterday, and the lymph nodes are no better, in fact it appears as though one is even larger. It only seems to be his groin ones, a few in the area are swollen, worse on one side. They are completely painless. There's no history of recent illness of any kind, no injury. Two of them are swollen enough that you can see them when he stands up, plain as day. The largest appears to be about 1" long now.
He ordered immediate blood work checking for CBC and a bunch of other things, and has sent an immediate referral to a urologist. In the meantime, I'm not stupid. I know what swollen lymph nodes can mean. I know it could be other things, but I'll admit I'm worried. I know one of the symptoms can be sweating at night - which my son has been complaining of. Sometimes he gets a bit short of breath, oddly enough not so much when he's playing, but when he's reading. He'll be reading and have to stop and catch his breath. I can't really think of anything else that stands out to me. He's always so healthy.
Anyways, I don't know what I'm looking for... input? Suggestions as to other things it could be? How big should a lymph node normally be in that area for a child? Also, to be certain that everything is ruled out, what tests should we be asking for?
A couple months ago we took our son (7) to his GP about the fact that he seemed to be leaking urine, not large amounts, but enough that you can smell it on him in the morning, sometimes at the end of the day. They did a urinalysis etc... and all was clear. We went back for follow up a month ago, and he did a physical exam, and noted that my son's lymph nodes in the groin area were a bit enlarged. At the time he decided to repeat the urinalysis, to check again for infection, and noted that if there was an infection (especially down there), that it could cause some swelling of the lymph nodes, which would go away within a couple weeks. He wanted to see us back in four weeks to check on the lymph nodes. (The urinalysis was again clear). So we went back yesterday, and the lymph nodes are no better, in fact it appears as though one is even larger. It only seems to be his groin ones, a few in the area are swollen, worse on one side. They are completely painless. There's no history of recent illness of any kind, no injury. Two of them are swollen enough that you can see them when he stands up, plain as day. The largest appears to be about 1" long now.
He ordered immediate blood work checking for CBC and a bunch of other things, and has sent an immediate referral to a urologist. In the meantime, I'm not stupid. I know what swollen lymph nodes can mean. I know it could be other things, but I'll admit I'm worried. I know one of the symptoms can be sweating at night - which my son has been complaining of. Sometimes he gets a bit short of breath, oddly enough not so much when he's playing, but when he's reading. He'll be reading and have to stop and catch his breath. I can't really think of anything else that stands out to me. He's always so healthy.
Anyways, I don't know what I'm looking for... input? Suggestions as to other things it could be? How big should a lymph node normally be in that area for a child? Also, to be certain that everything is ruled out, what tests should we be asking for?
COMMUNITY LEADER
People with overactive immune conditions tend to have unusual things happening with their immune system including the lymph nodes. So that should be encouraging for you :)
The Fx of diabetes explains why some of the tests were given.
I'd *guess* there is some immune condition that caused the node problem and also the growth problem. But you might have difficulty getting a doc to agree about that.
The Fx of diabetes explains why some of the tests were given.
I'd *guess* there is some immune condition that caused the node problem and also the growth problem. But you might have difficulty getting a doc to agree about that.
"Do you have a family history of autoimmune conditions?"
Yes, on the maternal side: I have Raynaud's, my father has Raynaud's, and my mother has Raynaud's, Lupus, Sjrogens. My mother, sister, aunt and grandfather all have Type 2 diabetes (I know they haven't ruled conclusively that that is an auto-immune disease, but recent discussions seem to suggest it is, or can be). On the paternal side: his grandfather has rheumatoid arthritis.
"Is he overweight?"
No, the opposite. He's quite small for his age. He's 7.5, and only 46.5" tall and still only 47 lbs. And I think he's lost a bit of weight lately.
Yes, on the maternal side: I have Raynaud's, my father has Raynaud's, and my mother has Raynaud's, Lupus, Sjrogens. My mother, sister, aunt and grandfather all have Type 2 diabetes (I know they haven't ruled conclusively that that is an auto-immune disease, but recent discussions seem to suggest it is, or can be). On the paternal side: his grandfather has rheumatoid arthritis.
"Is he overweight?"
No, the opposite. He's quite small for his age. He's 7.5, and only 46.5" tall and still only 47 lbs. And I think he's lost a bit of weight lately.
COMMUNITY LEADER
"His doctor just said that in the absence of infection, it's not normal for lymph nodes to be swollen."
Do you have a family history of autoimmune conditions?
"I'm pretty sure the doctor would know what's a lymph node"
Nope, not necessarily an easy thing to now just by looking and feeling. E.g.: cyst, lipoma, hernia.
I expect most of those blood tests are unrelated to the suspect nodes (except the CBC of course). Is he overweight?
Do you have a family history of autoimmune conditions?
"I'm pretty sure the doctor would know what's a lymph node"
Nope, not necessarily an easy thing to now just by looking and feeling. E.g.: cyst, lipoma, hernia.
I expect most of those blood tests are unrelated to the suspect nodes (except the CBC of course). Is he overweight?
For blood work he ordered your routine CBC, as well as Creatnine, Urea, TSH, A1C, and one other thing which I think was random glucose?
No, they haven't mentioned much of anything, other than needing to find out what's going on. His doctor just said that in the absence of infection, it's not normal for lymph nodes to be swollen.
I'm pretty sure the doctor would know what's a lymph node (at least I hope so, lol).
No to swimming in exotic locales as well.
I'm pretty sure the doctor would know what's a lymph node (at least I hope so, lol).
No to swimming in exotic locales as well.
COMMUNITY LEADER
"They've pretty well ruled out infection."
I don't know that such can ever be said for sure.
"And they're completely painless, so the doctor said unlikely that the nodes themselves are infected?"
Most likely true, yes. But not certainly true. Did anybody mention granuloma?
Everything is all about probabilities, unless a biopsy is done to know for sure.
Any swimming in an exotic locale? In other words, a parasite that a local doc wouldn't recognize.
A node should be bean shaped. Nodes don't get long and thin from an immune response, they stay bean shaped or get more round. But then we don't know for sure at this point if they even are lymph nodes.
You can ask for a sonogram. That can give a strong indication of being benign (such as presence of a fatty hilum), and set your mind at ease.
I don't know that such can ever be said for sure.
"And they're completely painless, so the doctor said unlikely that the nodes themselves are infected?"
Most likely true, yes. But not certainly true. Did anybody mention granuloma?
Everything is all about probabilities, unless a biopsy is done to know for sure.
Any swimming in an exotic locale? In other words, a parasite that a local doc wouldn't recognize.
A node should be bean shaped. Nodes don't get long and thin from an immune response, they stay bean shaped or get more round. But then we don't know for sure at this point if they even are lymph nodes.
You can ask for a sonogram. That can give a strong indication of being benign (such as presence of a fatty hilum), and set your mind at ease.
They've pretty well ruled out infection. He has not been sick in a looooong time, I mean not even a sniffle. And they're completely painless, so the doctor said unlikely that the nodes themselves are infected?
The two that are visible are long and thin. Kind of firm, rubbery feeling.
The two that are visible are long and thin. Kind of firm, rubbery feeling.
COMMUNITY LEADER
Hi, children tend to get more swollen nodes and relatively larger swollen nodes. A lymphoma is one of the least likely causes. Infection is the most likely and can cause all of his present symptoms.
What is the shape of the largest one? Long and thin or more bean shaped?
What is the shape of the largest one? Long and thin or more bean shaped?
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