Condition | Possible associated clinical features |
Malignancy | |
Lymphoma or leukemia | Persistent, or progressive, nontender cervical or generalized lymphadenopathy; constitutional symptoms (eg, fever, weight loss, fatigue) |
Neuroblastoma | Constitutional symptoms (fever, weight loss); abdominal mass; GI symptoms; proptosis; periorbital ecchymoses; Horner syndrome; opsoclonus myoclonus ataxia; palpable subcutaneous nodules; bone pain; hypertension; unilateral nasal obstruction |
Rhabdomyosarcoma | Localized, painless, enlarging mass; proptosis; ophthalmoplegia; nasal, aural, or sinus obstruction (without drainage) |
Thyroid cancer | History of external radiation to the head and neck; hoarseness; dysphagia; medullary thyroid cancer may be associated with multiple endocrine neoplasias |
Collagen vascular disease | |
Juvenile idiopathic arthritis | Arthritis/arthralgia; fever; rash; other systemic involvement (eg, hepatosplenomegaly, pericarditis, etc) |
Systemic lupus erythematosus | Arthritis/arthralgia; hematologic abnormalities (anemia, leukopenia, lymphopenia, thrombocytopenia); malar rash; oral ulcers; fever; renal disease |
Drugs | |
Phenytoin | Seizure disorder |
Carbamazepine | Seizure disorder |
Miscellaneous | |
Kawasaki disease | Fever; rash; nonexudative conjunctivitis; enanthem; swelling of hands and feet |
MIS-C (postinfectious) | Presentation may be similar to incomplete Kawasaki disease or toxic shock syndrome |
PFAPA | Recurrent fevers; aphthous stomatitis; pharyngitis; and adenitis |
Kikuchi disease | Fever; rash; systemic symptoms (fatigue, weight loss); leukopenia; anemia; usually occurs in young adult females |
Langerhans cell histiocytosis | Lytic bone lesions; rash (papular or eczematous); oral lesions (mass, gingivitis, ulcers, loose teeth); diabetes insipidus |
Hemophagocytic lymphohistiocytosis | Hepatomegaly; rash; neurologic findings (seizures, mental status changes); anemia; thrombocytopenia; most frequent at age <10 months, but may occur in older children |
Castleman disease | Lymph nodes may be >4 cm (1.6 inches); may have systemic symptoms (fever, night sweats, malaise); hepatosplenomegaly; anemia, thrombocytosis |
Kimura disease | Painless subcutaneous masses in head and neck; eosinophilia; increased IgE |
Postvaccination | Recent history of immunization (particularly diphtheria-tetanus-pertussis, polio, or typhoid fever vaccine) |
Sarcoidosis | Extensive enlargement of cervical nodes; facial eruption (flat-topped papules); weight loss; lethargy; fatigue, cough; bone lesions (eg, cystic or sclerotic focal lesions, osteopenia, osteoporosis) |
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