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Pristop k bolniku s povečanimi bezgavkami in vranico = Approach to the patient with enlarged lymph nodes and spleen
Roškar, Zlatko ; Borin, Peter ; Majal, Maja, 1975-
Povečane bezgavke (limfadenopatija) in povečana vranica (splenomegalija) sta pogosta klinična znaka, ki lahko predstavljata trd diagnostični oreh in terapevstki izziv. V prispevku so opisane ...značilnosti perifernega limfatičnega sistema, kamor spadajo bezgavke in vranica ter naštete bolezni, kjer se limfadenopatija (LA) in splenomegalija (SM) pojavljata. Največkrat gre pri LA za reaktivno povečane bezgavke in vzrok za nastanek pojasnimo iz klinične slike in poteka bolezni. V teh primerih dodatne preiskave niso potrebne. Drugače pa je pri povečanih bezgavkah, ki se ne zmanjšajo po enem mesecu. Te je potrebno vzročno opredeliti. SM pomeni tipljivo povečano vranico, ki sega pod levi rebrni lok. Običajno to pomeni bolezensko stanje, čeprav pri približno 3 % zdravih mladih ljudi lahko najdemo zmerno povečano vranico. Vzrok za SM je najpogosteje bolezen krvotvornih organov, pogosto je povečana vranica tudi pri okužbah, kroničnih vnetjih in pri portalni hipertenziji. Ostali vzroki so pri nas redki.
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