The thymus gland is called the central organ of the immune system, as well as the gland that produces the internal secret. It is here that progenitor cells turn into T-lymphocytes, which are directly involved in cellular and humoral immunity. In addition, about 20 substances are secreted from this gland as a secret. This includes a variety of hormones and components required for normal metabolism.
Maximum weight of the thymus is achieved during the neonatal period, since this organ takes up more than 4% of the weight of the child. Growth can take place during the first 15 years of a child's life, but then age involution is noted. As a result, glandular tissue turns into connective and fatty tissue.
Reasons
Thymomegaly in children, whose ICD-10 is E32, develops due to the presence of exogenous and endogenous factors, and in some cases they can be combined with each other. Quite often, this pathology is directly relatedwith burdened obstetric anamnesis of the mother. We are talking about abortions and miscarriages, as well as severe toxicosis during pregnancy and the presence of a Rh conflict. Modern doctors do not cancel the negative effect of drugs and alcohol on the thymus gland, which will further lead to the development of thymomegaly.
What do babies look like?
If the thymus has only slightly enlarged, there may be no clinical manifestations. In this case, we speak of an enlarged thymus syndrome. Expanded symptoms of the disease are observed with a significant increase.
Children diagnosed with thymomegaly can be distinguished due to characteristic phenotypic features:
- round body shape;
- poorly developed muscles;
- facial features are very large;
- light eyes and hairline;
- the transverse parameters of the body differ in increased sizes, especially such parts as the shoulders and chest, as well as the palms and feet, which are constantly getting cold;
- enlarged lymph nodes;
- skin is pale with a marble-like pattern, mild pigmentation and a rash.
Signs
Children with this disease have an increased appetite, they are often obese or overweight.
Illness is accompanied by other diseases. First of all, these are endocrine-metabolic pathologies that manifest themselves as thyroid dysfunction or hypocorticism, hypoparathyroidism. Diabetes may develop. Hernias are found: inguinal orumbilical.
Thymomegaly is accompanied by a change in pressure, which leads to arterial hypotension, arrhythmias. Provoke the disease and such deviations that are associated with squeezing vital organs. This is the first:
- Trachea. In this case, there is a constant cough, shortness of breath, and noisy breathing with wheezing.
- The vagus nerve. Its irritation leads to bradycardia, dysphonia, collapses.
- Swollen neck veins, cyanosis.
There is an underdevelopment of the genital organs. Girls suffer from uterine and vaginal hypoplasia, while boys may have phimosis or cryptorchidism.
Adenoids and tonsils are enlarged. SARS often occur, which are accompanied by a strong cough.
How to recognize?
You can recognize thymomegaly in children under one year old by the following signs:
- they are usually born with a lot of weight;
- femoral congenital defect may be found;
- weight may fluctuate: either sharply increased or reduced;
- all signs of rickets are determined;
- skin is pale but turns bluish when crying;
- regurgitation is too frequent;
- excessive sweating;
- venous mesh visible in chest area;
- cough occurs for no apparent reason, if the baby is kept in a horizontal position, it intensifies;
- high temperature persists for a long time, up to 38 degrees;
- there is an arrhythmia.
There is also a violation of sequential teething, the child lags behind in speech development, starts walking late.
How the degree of thymomegaly in children is determined
In pediatric endocrinology, the stage of development of thymomegaly is determined by the method of special measurements and by the external state of the thymus gland, according to the radiograph.
To diagnose thymomegaly in a child, a cardiothymicothoracic index (CTTI) is used. This indicator will be calculated by the doctor, based on the indications of the radiograph. It is necessary to measure the ratio of the area of the vascular bundle in the area of the bifurcation of the trachea to the size of the chest cavity in the area of the diaphragm.
Also in pediatric endocrinology, there is an option to identify the stage of the disease, focusing on the area of the shadow of the gland, which can be fixed by x-ray.
Conventionally, a person has three anatomical parts of the chest. The degree of thymomegaly in a sick child is determined by the area of the child's chest affected by the level of growth of the thymus gland.
What indicators?
The following degrees of thymus growth are distinguished:
- 1 degree. KKTI indicator within 0.33-0.37 units, thymus gland in the area of the upper third of the chest.
- 2 degree. The KKTI indicator is within 0.37-0.42 units, the organ occupies an area of no more than 2/3 of the children's chest.
- 3 degree. The KKTI indicator is above 0.42 units, the gland occupies an area of 2/3 or more of the chest area.
Diagnosis
One of the most objective methods for recognizing thymomegaly are studies using X-ray diagnostics and ultrasound. Inspection, palpation and percussion are used at the initial stage of diagnosis. An important factor in this is the experience of the doctor.
When establishing thymomegaly using X-ray diagnostics, it should be taken into account that the standard shadow visibility of the thymus does not go beyond the shadow projection of the child's heart and vascular bundle. This situation applies to children of different ages.
Studies conducted by scientists have revealed the limiting norms of weight and volume of the thymus, going beyond which is a manifestation of thymomegaly. Most accurately, these indications are established using ultrasound, during which the subject of the study is the thymus gland, abdominal organs and adrenal glands. An ultrasound of the thymus determines the degree of the disease.
At the same time, laboratory blood tests are carried out for excess of the norm of T-lymphocytes, hormones, a cardiogram is assigned.
Studies of this disease revealed a decrease in the immunity of the child's body and a high susceptibility of the child to SARS, therefore, when making a diagnosis, the child's history is studied.
About the problem
Thymus or thymus gland is an organ of lymphocytopoiesis, in which lymphoid cells are formed that are responsible for the functioning of the child's immune system. The thymus gland in childhood has a maximum size. Thymomegaly is a diseaseassociated with an increase in the size and weight of the named organ, it manifests itself in children from a very young age.
Children with thymomegaly, as already mentioned, are overweight, increased appetite, lack of development of muscle tissue, changes and underdevelopment of the forms of the genital organs, impaired eruption of milk teeth, developmental delay, speech defects.
The thymus gland compresses the vital organs of the child, which can manifest itself in swelling of the veins in the neck, shortness of breath, coughing and bluish skin color. In some cases, the disease may occur without any pronounced symptoms.
How is therapy going?
Drug treatment of thymomegaly in children, the symptoms of which are higher, is prescribed by a pediatrician, based on the degree and severity of the disease and on the basis of the conclusions of an immunologist and an endocrinologist. In medical practice, therapeutic treatment of mild forms of thymomegaly is not performed. It is recommended that the child adhere to a balanced diet, not be stressed and beware of colds, and visit the pediatrician regularly. Breastfeeding is indicated for newborns.
At the second stage of the disease, adaptogens and biostimulants based on plant components are prescribed, which can increase the body's resistance to harmful environmental factors.
In some cases, preparations based on an extract from the thymus gland of cattle are prescribed.
When a child develops adrenal insufficiency, injections of potassium solutions and cardiac glycosides are administered.
In the laststage of the disease and in the preoperative period, prescribe steroid hormones glucocorticoids: prednisalone and hydrocortisone. The dosage is selected individually.
In order not to provoke the degeneration of thymomegaly into more serious diseases, regular monitoring of the child's he alth and the prescribed treatment are necessary.
Prevention
Most often, a normal-sized thymus gland develops in a child by the age of six, but the child should still be registered with doctors such as a pediatrician, immunologist and endocrinologist, as well as undergo regular preventive examinations.
Prevention of the disease can be the correct and careful planning and conduct of labor, and this is maintaining a he althy lifestyle, before planning a child and during pregnancy, passing all the necessary examinations both during pregnancy and after, already a newborn. Breastfeeding is desirable, as mother's milk contains a large amount of antibodies and other beneficial substances, thanks to which the child will develop properly.
While breastfeeding, the mother should avoid stress and unhe althy lifestyle. If the child is bottle-fed, then you should consult a doctor who will advise a quality mixture.
In the house you need to observe the correct microclimate, often carry out wet cleaning and ventilate. If the child has increasedthymus, then parents need to protect it from stressful situations, as well as from contact with infected people.
