2nd order laboratory parameters – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification.
- Small blood count
- Differential blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Serological tests – if bacterial, viral or parasitic diseases are suspected.
- Cervical LK swelling: common causes: group A streptococcus; Epstein-Barr virus, toxoplasmosis, nonspecific viral infections (see Differential Diagnoses). Rare causes: Angina Plaut-Vincenti, diphtheria, tuberculosis.
- Occipital LK swellings: Rubella.
- Peripheral LK swelling: reactive lymphadenitis in bacterial infection, cat scratch disease, syphilis, tularemia, ulcus molle, infections with herpes simplex virus; chlamydia. After a stay in the tropics or subtropics: parasitoses in consideration!
- Generalized LK swelling: Common causes: Epstein-Barr virus, cytomegalovirus, toxoplasmosis. Rare causes: Adenovirus, brucellosis, chlamydia, coxsackie, HIV, tuberculosis, rubella, tularemia.
- Rheumatism diagnostics – CRP (C-reactive protein) or ESR (sedimentation rate); rheumatoid factor (RF), CCP-AK (cyclic citrulline peptide antibodies), ANA (antinuclear antibodies).
- Thyroid parameters – TSH
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- LDL
- Genetic diagnostics – for suspected hereditary diseases.
- Tumor markers – depending on the suspected diagnosis.
- Lymph node biopsy (histological examination if necessary also microbiological examination, eg due toTbc).
