From Big Medical Encyclopedia

STATUS THYMICOLYMPHATICUS (synonym: timiko-lymphatic state, timiko-lymphatic constitution) — the inborn constitutional feature of an organism (constitutional type) which is shown excessive development of hypodermic cellulose, pastosity, pallor of skin, a hyperplasia of lymphoid bodies (palatine tonsils, lymph nodes, a spleen), increase in a thymus, a hypoplasia of cardiovascular system and adrenal glands. Involution of a thymus is a little expressed and occurs after usual.

For persons from S. t. it is characteristic biol. instability, a cut can be caused sudden death from influence nek-ry, even insignificant, by factors (e.g., at inf. diseases, injuries, inoculations, an anesthesia at operation, physical or emotional pressure). The long time sudden death was connected with increase in a thymus. A cause of death at the same time considered the mechanical pressure of the increased thymus upon a trachea; anomaly of the constitution in the form of inborn insufficiency of cardiovascular system, as a result a cut emergence of an attack of a ciliary arrhythmia from the death is possible; toxic impact on heart of an excess secret of a thymus; the vagotonia connected with functional insufficiency of adrenal system; allergic fluid lungs; electrolytic shifts in a myocardium; hormonal insufficiency.

Though reason of sudden death of npuS. t. still finally it is not found out, in a crust, time exists opinion that it is connected with dysfunction of bark adrenal glands (see) and disturbances of interrelations of closed glands. Such explanation finds more and more supporters.

So, G. Selje, proceeding from close pathogenetic connection of functions of bark of adrenal glands and a thymus in protective and adaptation reaction of an organism, considered that sudden death is caused by insufficiency of bark of adrenal glands.

Function of a thymus is in correlative communication with functions of other hemadens, including adrenal glands, exerting on them the braking impact. The researches of activity of adrenal glands conducted by E. A. Dombrovska in 1965 at S. t. allowed to prove their functional insolvency — considerable depletion of bark of adrenal glands lipids, keto-steroids, cholesterol.

Thus, reason of S. t. consider insufficient secretion of glucocorticoids bark of adrenal glands, and the main reason for sudden death at this state — acute adrenocortical insufficiency. However the mechanism of development of this state remains not clear.

For persons from S. t. are characteristic as it was specified, pastosity, pallor and nek-paradise the istonchennost of skin, friability of hypodermic cellulose, a hydrolability and tendency to increase in weight connected with disturbance of a water salt metabolism, a hypomyotonia about a nek-eye increase in mass of muscles, a hypoplasia of cardiovascular system (a narrow aorta, «drop» heart). Children are adynamic, reaction at them is slowed down, tendon jerks are lowered; lability of a nervous system, a squeaky voice, long ringing crying are characteristic. At such children frequent vomiting, stidor breath (see the Stridor), an apnoea (see Breath), cyanosis of a nasolabial triangle (at rest and during sleep), manifestations of cardiovascular insufficiency are possible. The underdevelopment of outside and internal generative organs, changes of a skeleton is noted (e.g., length of extremities is more than length of a trunk). Weakening of protective forces of an organism at S. t. is one of the reasons of decrease in body resistance to viral and bacterial infections and his tendency to allergic reactions. Children are predisposed to quinsy, rhinitis, tracheitis, conjunctivitis, a dermatosis. Children with the increased thymus quite often (on the first year of life) have pneumonia with a recurrent current.

Diagnosis of S. t. put a wedge on the basis. pictures, anamnestic data (adversely proceeding pregnancy at mother, the large weight of the child at the birth), and also features of the period новорожденное™ (e.g., hard proceeding pneumonia, frequent acute respiratory diseases).

For size discrimination of a thymus carry out it rentgenol. a research in a direct and side projection. For assessment of a functional condition of a thymus at its increase use indicators of a condition of immune system of an organism (see. And mmunologi-chesky insufficiency, the Immunomorphology), and also determine the level of hormones in an organism. At the same time the high level of somatotropic hormone and falloff of maintenance of AKTG, cortisol and its metabolites are characteristic.

The differential diagnosis is carried out with new growths and cysts, coming from a thymus (see) also by mediastinums (see).

Treatment comes down to purpose of a diet with restriction of lipids; milk, potatoes, beans are especially useful. The overeating is not allowed in order to avoid development of obesity.

Timomegaliya (increase in a thymus) shall be considered as an adverse background at acute inf. diseases, at operative measures, during the carrying out preventive inoculations. In these cases purpose of Dimedrol, Pipolphenum, glucocorticoids (a hydrocortisone, Prednisolonum), and also the drugs stimulating immunol is shown. reactivity of an organism (apilak, pentoxyl, eleuterokokk, Dibazolum).

Early detection of a timo-megaliya and definition at the child of S. t. allows to allocate such children in risk group on an immunodeficiency, development of acute and chronic adrenal insufficiency, on tendency to allergic reactions and a heavy current acute inf. diseases, pneumonia. For ensuring normal development of the child with a timomegaliya and prevention of sudden death it is necessary to preserve it against acute inf especially. diseases within the first 3 years of life. It is necessary to delay preventive inoculations; if it is impossible, they should be seen off against the background of the hyposensibilizing therapy (Dimedrol, Suprastinum, etc.) for the prevention of complications. Children with a timomegaliya shall be on the obligatory dispensary account. Within the first 3 years of life of times a year to them make a X-ray analysis of a thorax in direct and side projections. Such children are not recommended to be sent to a day nursery.

See also Thymus .

Bibliography: Aliyev M. G., Guseynov Sh. G. and Kurbanov T. G. The hormonal and immunological status at children with a hyperplasia of a thymus, Probl. endocrinins., t. 28, No. 5, page 42, 1982; Dergachev I. S. A pathogeny of sudden death at early children's age, Pediatrics, No. 1, page 3, 1941; Dombrovsky E. A. Patomorfologiya of adrenal glands at timiko-lymphatic states, Probl. endocrinins., t. 2, No. 5, page 42, 1965; Krasnoperova K. E. The anamnesis of inoculations with a hyperplasia of a thymus, Kazansk. medical zhurn., t. 62, No. 4, page 72, 1981; it, Criteria of body weight and a thymus gland at children of early age in aspect of an adaptation syndrome, Pediatrics, No. 2, page 26, 1982; Kurbanov T. G. and Aliyev M. G. Features of secretory activity of an adenohypophysis at children with a timomegaliya, Probl. endocrinins., t. 26, No. 1, page 31, 1980; they, Physiology and pathology of a thymus, Baku, 1983; Matkovsky T. B. Kliniko-immunologichesky features at children with increase in a thymus gland, Pediatrics, No. 11, page 31, 1979; Medvedev N. Yu. A syndrome of sudden death at children, Arkh. patol., t. 40, century 9, page 79, 1978; Kemp W. N. Status thymicolymphaticus, A nutritional-endocrine syndrome, Vancouver, 1959; To o k O. Y. S. Status thymicolymphaticus, S. Afr. med. J., v. 30, p. 653, 1956; S e 1 at e H. Thymus and adrenals in the response of the organism to injuries and intoxications, Brit. J. exp. Path., v. 17, p. 234, 1936.

S. A. Zhdanova, V. A. Tabolin.