CLINICAL AND ANAMNESTIC FEATURES IN CHILDREN WITH SEVERE ACCIDENTAL INVOLUTION OF THE THYMUS AND CHILDREN WITH NORMATIVE MORPHOMETRIC PARAMETERS OF THIS ORGAN
Main Article Content
Abstract
This study is devoted to the study of clinical and anamnestic features in children with different morphometric parameters of the thymus. The relevance of the work is due to the lack of uniform normative sonographic criteria for assessing the size of the thymus gland and the need to clarify the effect of its condition on the incidence of respiratory diseases.
Study objective – development of regional normative ultrasound sizes of the thymus in children of different age groups and analysis of clinical and anamnestic features in children with normal and critically involutional morphometric parameters of this organ.
Materials and methods. Ultrasound examination of the thymus was performed in 850 children aged from 1 month to 6 years in the Kemerovo region. Three groups were formed: children with thymomegaly, microthymus and normal parameters. A comparative analysis of morbidity and anamnestic data, including medical and social factors and pregnancy characteristics, was carried out.
Results of the study. The percentile standards for the weight and volume of the thymus for children in Kuzbass were established. A significant prevalence of respiratory pathology was revealed in children with bipolar thymus states, especially in the group with microthymus. A relationship was established between unfavorable pregnancy factors (gestosis, intrauterine infection, chronic generalized pregnancy) and the development of microthymus. Children with microthymus demonstrated a higher frequency of acute respiratory viral infections (RR = 3.1), adenoiditis (RR = 3.06) and otitis (RR = 2.86) compared to the control group.
Conclusions. The regional standard indicators of thymus size in young children were obtained. A high association of bipolar thymus states with increased morbidity was proven. The most pronounced disorders were detected in children with microthymus, which requires special attention to this category of patients. The results emphasize the importance of taking into account predisposing factors (occupational hazards, alcohol dependence of parents, pregnancy complications) and the dynamics of thymus changes when assessing the risks of developing pathology in children. Further study of the immune status of such children at an older age is necessary.
Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Zairatyants OV, Serov VV, Kuzmenko LG. New data on thymomegaly and immune deficiency syndrome. Archives of Pathology. 1990; 52(6): 33-39. Russian (Зайратьянц О.В., Серов В.В., Кузьменко Л.Г. Новые данные о тимомегалии и синдроме иммунного дефицита //Архив патологии. 1990. Т. 52, № 6. С. 33-39)
Kuzmenko LG, Smyslova ZV, Kiseleva NM, Bystrova OV, Agarwal RK. On the issue of the thymus, related terminology and the health status of children with a large thymus. The Journal of scientific articles Health and Education Millennium. 2015; 17(4): 97-107. Russian (Кузьменко Л.Г., Смыслова З.В., Киселева Н.М., Быстрова О.В., Агарвал Р.К. К вопросу о тимусе, связанной с ним терминологии и состоянии здоровья детей с большим тимусом //Журнал научных статей Здоровье и образование в XXI веке. 2015. Т. 17, № 4. С. 97-107)
Cowan JE, Takahama Y, Bhandoola A, Ohigashi I. Postnatal Involution and Counter-Involution of the Thymus. Front Immunol. 2020; 11: 897. doi: 10.3389/fimmu.2020.00897
Esmurzieva ZI, Kuzmenko LG, Osadchaya OA, Kask LN. Morphometry of thymus in fetuses of different gestational age and term newborns by ultrasound examination. Pediatrics. Journal named after G.N. Speransky. 2015; 94(1): 68-72. Russian (Эсмурзиева З.И., Кузьменко Л.Г., Осадчая О.А., Каск Л.Н. Морфометрия тимуса плодов различного гестационного возраста и доношенных новорожденных детей по данным ультразвукового исследования //Педиатрия. Журнал им. Г.Н. Сперанского. 2015. Т. 94, № 1. С. 68-72)
Ansari AR, Liu H. Acute Thymic Involution and Mechanisms for Recovery. Arch Immunol Ther Exp (Warsz). 2017; 65(5): 401-420. doi: 10.1007/s00005-017-0462-x
Savino W. The thymus is a common target organ in infectious diseases. PLoS Pathog. 2006; 2(6): e62. doi: 10.1371/journal.ppat.0020062
Kuzmenko LG, Simenikhina KN, Neizhko LYu, Sarker L, Bakhrysheva SI. Estimation of thymus dimension in children of two first years of life by ultrasound scanning. Pediatrics. Journal named after G.N. Speransky. 2002; 81(6): 22-26. Russian (Кузьменко Л.Г., Сименихина К.Н., Неижко Л.Ю., Саркер Л., Baxpyшева С.И. Оценка величины вилочковой железы у детей первых двух лет жизни по данным ультразвукового сканирования //Педиатрия. Журнал им. Г.Н. Сперанского. 2002. Т. 81, № 6. С. 22-26)
Manchanda S, Bhalla AS, Jana M, Gupta AK. Imaging of the pediatric thymus: Clinicoradiologic approach. World J Clin Pediatr. 2017; 6(1): 10-23. doi: 10.5409/wjcp.v6.i1.10
Ivanovskaya TE, Zairatyants OV, Leonova LV, Voloshchuk IN. Pathology of the thymus in children. St. Petersburg: Sotis, 1996. 270 p. Russian (Ивановская Т.Е., Зайратьянц О.В., Леонова Л.В., Волощук И.Н. Патология тимуса у детей. СПб.: Сотис, 1996. 270 с.)
Morozov SL. Frequently ill children. A modern view of a pediatrician. Russian Medical Journal. Medical Review. 2019; 8: 7-9. Russian (Морозов С.Л. Часто болеющие дети. Современный взгляд педиатра //РМЖ. Медицинское обозрение. 2019. № 8. С. 7-9)
Kozlov VA. The determining role of the thymus in the immunopathogenesis of autoimmune, oncological and infectious diseases. Medical Immunology. 2023; 25(1): 39-58. Russian (Козлов В.А. Определяющая роль тимуса в иммунопатогенезе аутоиммунных, онкологических и инфекционных заболеваний //Медицинская иммунология. 2023. Т. 25, № 1. С. 39-58.) doi: 10.15789/1563-0625-DRO-2591
Kuzmenko LG, Neizhko LYu, Smyslova ZV, Bystrova OV, Esmurzieva ZI, Vakhrusheva SI, Ryakhina NN, Nkane Nzola MM, Uddin MD. Evaluation of thymus mass in children of different ages based on ultrasound scanning. Pediatrics. Journal named after G.N. Speransky. 2014; 93(3): 56-61. Russian (Кузьменко Л.Г., Неижко Л.Ю., Смыслова З.В., Быстрова О.В., Эсмурзиева З.И., Вахрушева С.И., Ряхина Н.Н., Нкане Нзола М.М., Уддин М.Д. Оценка массы тимуса у детей разного возраста по данным ультразвукового сканирования //Педиатрия. Журнал им. Г.Н. Сперанского. 2014. Т. 93, № 3. С. 56-61)
Sirotina O.B. Ultrasound examination of the thymus in children in norm, in some diseases and conditions: Abstr. dis. … doctor of medical sciences. M., 2011. 38 p. Russian (Сиротина О.Б. Ультразвуковое исследование тимуса у детей в норме, при некоторых заболеваниях и состояниях: Автореф. дис. … докт. мед. наук. М., 2011. 38 с.)