An enlarged thymus gland in infants can cause disturbances in cellular immunity, reduce the body's ability to resist infections and cause the development of autoimmune diseases. But pathology in most cases is not dangerous. This most important organ of the immune system grows up to about ten years of age, especially active growth is observed in childhood. If the baby has an enlarged thymus gland, does this condition require treatment?
Thymus function
The thymus gland, or thymus, determines the state of immunity. The gland is located in front of the sternum, ending at the root of the tongue. An organ is formed at the very beginning of fetal development. The thymus is initially small in size, but increases with time and ceases growth during maturity. In adults, when immunity is already formed, the gland atrophies as unnecessary. But until this time, it is important to monitor the condition of the thymus gland in order to prevent excessive enlargement.
An internal secretion organ is necessary for the normal functioning of the body, but for a child of the first years of life, the thymus is especially important because it protects an incompletely formed immune system from various diseases. The thymus gland provides the synthesis of T-lymphocytes, which effectively fight against pathogenic microorganisms, infectious and viral agents. Thymus is an important part of the immune system, with problems with which the body becomes susceptible to negative internal factors and environmental risks, and the general well-being of the child worsens.
Thymus dimensions: normal
The size of the thymus gland is estimated in units of CTI - this is the cardiotymicothoracic index. To determine this indicator, in the process of ultrasound, the anteroposterior size of the thymus and the width of the lobes are measured. Normally, the volume of the thymus gland in children under two years is up to 0.33% of body weight, a maximum of 0.4% is reached in three to four months. At the age of two to three years, the normal volume of an organ varies from 11 to 33 cm 3 . For an accurate assessment, the thymus mass and index are calculated (thymus mass ÷ body weight of the child x 100%).
For newborns, the norm is TI in the range from 0.18 to 0.66%, aged from one to three months - 0.24-0.73%, from four to six months - 0.13-0.58%, from seven months to a year - 0.13-0.57%. The relative weight of the thymus gland per kilogram of the weight of the newborn child should be 4.2 g, aged one to five years - 2.2 g, the total weight of the thymus from birth to year - 13.26 g. There are summary tables of the ratio of width, the thickness and length of the lobes, which allow instrumental methods to diagnose an enlarged thymus gland in an infant.
Possible pathologies
With an increase in CTI, an enlarged thymus gland in a child up to a year is diagnosed. This condition is characterized by the fact that the body under the influence of certain internal or external factors changes its size, which negatively affects its functioning. In medical practice, the pathology is called thymomegaly. Hyper- or hypoplasia can be diagnosed: with thymus hyperplasia, the tissue grows, a neoplasm is formed, and with hypoplasia, T-lymphocyte function is impaired. It is possible to independently detect the presence of problems in the newborn, only focusing on indirect symptoms, and instrumental methods will allow accurate diagnosis of the pathology.
Symptoms of iron problems
If a child has an enlarged thymus gland (thymus), usually this condition is accompanied by symptoms of decreased immunity. Frequent colds and cough are possible, which is not associated with influenza or SARS and increases in a horizontal position, an increase in adenoids, lymph nodes or tonsils. An enlarged thymus gland syndrome is manifested by such signs: heart rhythm disturbance, rapid weight gain or weight loss, pallor, frequent regurgitation, sweating, venous network on the chest, decreased muscle tone, blueness of the skin with crying and tension, overweight at birth, and other developmental abnormalities ( syndactyly, hernia, dislocation of the hip).
Stages of change
In most cases, a slightly enlarged thymus in an infant does not require treatment, but the doctor will determine the degree of pathology. This is necessary to make sure that the disease is not a threat, but so far requires only observation. The boundary indicators of the TI index for the first degree are from 0.33 to 0.37. The second degree is diagnosed with CTI 0.37-0.42, the third - over 0.42. Some doctors talk about the disease only with an increase in CTI above 0.38.
To determine the severity of the pathology, the practitioner can use another way (diagnosis according to E. Dadambaev). To take into account the degree of enlargement of the thymus gland in the baby, each half of the chest at the level of the third rib is conventionally divided into three equal parts vertically and horizontally. The increase is classified into noticeable (first degree) and significant (second degree). Moreover, the accuracy of diagnosis depends on the qualifications of the doctor and is evaluated subjectively.
Reasons for the development of pathology
Why is the thymus gland enlarged? It is rather difficult to establish the reason for the increase in the thymus in an infant. The condition may be associated with adverse heredity or a temporary violation that occurs due to imperfections and malfunctions in the formation of the child's body. As a rule, the thymus gland comes back to normal on its own, but subject to certain preventive measures. But if there is no appropriate treatment, and the degree of pathology is significant, a number of autoimmune diseases may develop.
Why is the thymus gland in a child enlarged? Among the factors that affect the increase in the size of the thymus can be listed:
- pathology of the development of the fetus during pregnancy of the mother;
- infectious diseases suffered by a woman (especially in the first trimester);
- complicated obstetric history (abortions, miscarriages, gynecological diseases in the past, primary miscarriage);
- the use of certain medications;
- pregnancy complications: Rhesus conflict, late toxicosis;
- complications in childbirth (weakness of labor, asphyxia, birth trauma, jaundice, sepsis);
- various gene abnormalities;
- premature birth;
- late pregnancy.
Diagnosis of thymomegaly
If a pediatrician or narrow specialists are suspected of having an enlarged thymus gland in an infant, they will study the mother’s history and features of the course of pregnancy, the neonatal period and the anthropometric data of the child (weight and height gain, birth indicators). Confirm or refute the diagnosis can only instrumental and laboratory diagnostic methods: ultrasound, x-ray of the sternum, immunogram. Ultrasound and x-ray will allow you to determine the size of the gland and calculate CTI, and in blood tests for pathology, a reduced concentration of T-lymphocytes, a limitation of the functional activity of these cells, a decrease in the number of immunoglobulins A and G are noted.
Treatment for enlarged thymus
Slightly enlarged thymus glands in infants do not require specific treatment. At the first and second stages of the pathology, it is necessary to ensure monitoring in dynamics and to carefully consider the state of health of the child. It is necessary to establish breastfeeding, ensure sufficient motor activity, to limit the contact of the baby with infectious patients. If breastfeeding for some reason is not possible, then you should choose a mixture with a high content of beneficial elements and vitamins. So, the main recommendations are aimed at naturally strengthening the child’s immunity.
Special drug treatment is necessary with a significant increase in the thymus or the presence of complications. With a severe course of pathology, the question of the appropriateness of surgical intervention is decided. In the period of preparation for surgery and in the presence of severe disorders caused by thymomegaly, glucocorticosteroids are prescribed. To correct the body's immune defenses, a course of natural stimulants and adaptogens is recommended. The treatment regimen is selected individually.
Complications and consequences
A significant increase in the thymus gland in an infant can provoke the development of severe allergic reactions and autoimmune diseases, endocrine disorders (diabetes, obesity, and so on). Children with increased thymus significantly increase the risk of sudden death syndrome. Common infectious diseases with thymomegaly can be complicated by an increase in lymph nodes, abdominal pain, otitis media, and heart rhythm contractions. In children with this diagnosis, colds and infectious diseases are more often observed.
Forecast for enlarged thymus
An enlarged thymus gland in infants most often does not require specific treatment. This organ grows intensively in the first years of life, especially in response to vaccination or previous diseases. This is a natural process of forming immunity. Thus, if the thymus is slightly increased in the infant, this is a normal variant. After two years (if the situation does not normalize), one can already talk about pathology, but, as a rule, by the age of five or six, the thymus gland stops growing. In the future, dynamic observation is simply necessary. With a significant increase in thymus, it is necessary to strictly adhere to the recommendations of doctors. In most cases, the prognosis is favorable.