Open AccessNodular lymphoid hyperplasia in common variable immunodeficiency syndrome mimicking familial adenomatous polyposis on endoscopy
Author(s) -
Mahsa Molaei,
Alireza Kaboli,
Alireza Modares Fathi,
Reza Mashayekhi,
Shervin Pejhan,
Mohammad Reza Zali
Publication year - 2009
Publication title -
indian journal of pathology and microbiology/indian journal of pathology and microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.217
H-Index - 31
eISSN - 0974-5130
pISSN - 0377-4929
DOI - 10.4103/0377-4929.56152
Subject(s) - common variable immunodeficiency , lymphoid hyperplasia , medicine , immunodeficiency , gastroenterology , gastrointestinal tract , hyperplasia , duodenum , diarrhea , stomach , ileum , immunology , pathology , immune system , antibody , lymphoma
Common variable immunodeficiency syndrome (CVID) includes a heterogeneous disorder characterized by reduced levels of IgG, IgA or IgM, and recurrent bacterial infections with normal T-cell immunity in 60% of patients. It affects the gastrointestinal tract as the largest immune organ with a wide spectrum of symptoms and signs. We present a case of nodular lymphoid hyperplasia (NLH) of the small intestine in a 31-year-old man admitted for evaluation of chronic diarrhea. Upper and lower gastrointestinal endoscopy revealed multiple polyps in the stomach, duodenum, ileum, and large intestine mimicking familial adenomatous polyposis (FAP). Although he had no history of recurrent infection, immunological profiles were in favor of CVID. We emphasize the importance of considering CVID in any patient with gastrointestinal manifestations even in the absence of recurrent bacterial infections. Diagnostic delay results in more morbidity and complications in untreated patients.