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Headache, Sore Throat, Anxiety, Tiredness And Swollen Lymph Nodes In Neck. Prognosis?

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Posted on Fri, 22 Mar 2013
Question: child has swollen lymph nodes in neck, back of neck at base of skull and in arms, headaches, constat sore throats,tired and anxiety. going on for 3 years. doc did one cbc two years ago and an ultrasound. no further testing. being told some people just have swolen lymph nodes...woulnd't she have always had them then? my ten year old daughter tells me about theese lumps daily and asks what am I going to do to figure it out. what tests do i need to have done? seems to me at the very least should be repeating a cbc every 6 months at least to see where she lies on the normal scale. I feel helpless and like I am letting my child down, PLEASE HELP.
doctor
Answered by Dr. Uma Rajah Ananth (26 minutes later)
Hi,
Welcome to HCM!

I can understand your concern with this chronic problem!

A few questions!
Does she have weight loss or poor weight gain?
Does she have fever esp in the evenings?
Are there any other signs like lack of appetite or enlargement of liver,spleen etc?( as determined by doctors)
Are the nodes increasing in size or decreasing in size over these 3 years?

There are many causes for lymph node enlargement in kids.

If I am in your doctor's place I would definitely do the following.

CBC and ESR
X-ray chest.
Biopsy of one of the superficial lymph nodes.
Mantoux test
Viral studies including that for CMV.

Once these basic tests are done, then some of the most common causes are ruled out and you can be rest assured that there is nothing to worry!

Anyway ,keep this to your self and discuss with the doctor on next visit, but let not your daughter worry about the possibilities and get anxious.

All the best.
God bless
Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth (3 days later)
can I ask what cmv is? and also what does a mantaux test reveal? thank you!
doctor
Answered by Dr. Uma Rajah Ananth (7 minutes later)
Hi,
CMV is cytomegalovirus- a type of virus that presents with generalised lymph node swellings and can affect a new born baby also .

Mantoux test is done to look for tuberculosis - it is done by giving a small injection into the skin of the forearm and look for reaction after 48 hrs in the site of injection.

Even though tuberculosis is not that common in your place ,still it is worth looking into.

Take care
Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Uma Rajah Ananth (3 minutes later)
I would say poor weight gain, she was in like 80th percentile and then seemed to stop now like 40th. haven't noticed fevers..she hardley ever has one even when really sick, she does however feel sick nightly. stomach pain often told it's constipation have had ultrasound done and told thats what was going on. I am so confused at this point I couldn't say for sure if nodes have grown or shrunken doc is not monitoring them in any way, daughter gets upset cause somwtimes doc says can't feel certain ones I can cause she has me feel them often, now the one on back of neck was thought to be new but it may have XXXXXXX there for awhile and grown? if you press hard on them it causes pain, I am always being told that if they were something bad they wouldn't hurt at all. thank you so much! I am lost i trust her doc fully and thats why I have let it go so long but a mothers intuition is saying do something NOW..ALONG TIME AGO! I dont know how to approach her doc. without insulting her abilitly and sensitivity.
doctor
Answered by Dr. Uma Rajah Ananth (7 minutes later)
Hi,
yes,it is a delicate situation.!

Don't mention that another doctor has suggested - because it will affect her ego!

You can say that you and your daughter are concerned and whether a biopsy will be possible!!!
,
May be she is correct as she has been examining the child but having a doubt cleared is always welcome.

Good luck
Dr Uma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Uma Rajah Ananth

Pediatrician, Neonatology

Practicing since :1970

Answered : 891 Questions

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Headache, Sore Throat, Anxiety, Tiredness And Swollen Lymph Nodes In Neck. Prognosis?

Hi,
Welcome to HCM!

I can understand your concern with this chronic problem!

A few questions!
Does she have weight loss or poor weight gain?
Does she have fever esp in the evenings?
Are there any other signs like lack of appetite or enlargement of liver,spleen etc?( as determined by doctors)
Are the nodes increasing in size or decreasing in size over these 3 years?

There are many causes for lymph node enlargement in kids.

If I am in your doctor's place I would definitely do the following.

CBC and ESR
X-ray chest.
Biopsy of one of the superficial lymph nodes.
Mantoux test
Viral studies including that for CMV.

Once these basic tests are done, then some of the most common causes are ruled out and you can be rest assured that there is nothing to worry!

Anyway ,keep this to your self and discuss with the doctor on next visit, but let not your daughter worry about the possibilities and get anxious.

All the best.
God bless
Dr Uma