Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection.
Background: Nodular lymphoid hyperplasia of gastrointestinal tract is a rare disorder, often associated with immunodeficiency syndromes. There are no published reports of its association with Helicobacter pylori infection.Methods: From March 2005 till February 2010, we prospectively followed all pat...
| Publicado en: | BMC Gastroenterology Vol. 11; no. 1; pp. 36 - 37 |
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| Autores principales: | , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104712371&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104712371 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1471230X 1CHO jtl: BMC Gastroenterology issn: 1471230X maglogo: N pubinfo: dt: 2011 vid: 11 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 104712371 NLM21481240 2011070427 10.1186/1471-230X-11-36 NLM21481240 PMC3094314 104712371 ppf: 36 ppct: 1 formats: tig: atl: Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection. aug: au: Khuroo, Mehnaaz S Khuroo, Naira S Khuroo, Mohammad S affil: Consultant Gastroenterology, Digestive Diseases Centre, Srinagar, Kashmir, India. khuroo@yahoo.com. sug: subj: Duodenal Diseases Microbiology Duodenal Diseases Pathology Helicobacter Infections Pathology Helicobacter Pylori Lymphatic Diseases Microbiology Lymphatic Diseases Pathology Adult Antibiotics Therapeutic Use Celiac Disease Diagnosis Celiac Disease Microbiology Prospective Studies Duodenal Diseases Drug Therapy Female Helicobacter Infections Drug Therapy Helicobacter Pylori Drug Effects Hyperplasia Microbiology Hyperplasia Pathology Immunoglobulins Blood Disaccharides Metabolism Male Middle Age Severity of Illness Indices Young Adult Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: Nodular lymphoid hyperplasia of gastrointestinal tract is a rare disorder, often associated with immunodeficiency syndromes. There are no published reports of its association with Helicobacter pylori infection.Methods: From March 2005 till February 2010, we prospectively followed all patients with diffuse duodenal nodular lymphoid hyperplasia (DDNLH). Patients underwent esophagogastroduodenoscopy with targeted biopsies, colonoscopy, and small bowel video capsule endoscopy. Duodenal nodular lesions were graded from 0 to 4 based on their size and density. Patients were screened for celiac sprue (IgA endomysial antibody), immunoglobulin abnormalities (immunoglobulin levels & serum protein electrophoresis), small intestine bacterial overgrowth (lactulose hydrogen breath test), and Helicobacter pylori infection (rapid urease test, and histological examination of gastric biopsies). Patients infected with Helicobacter pylori received sequential antibiotic therapy and eradication of infection was evaluated by 14C urea breath test. Follow up duodenoscopies with biopsies were performed to ascertain resolution of nodular lesions.Results: Forty patients (Males 23, females 17; mean age ± 1SD 35.6 ± 14.6 years) with DDNLH were studied. Patients presented with epigastric pain, vomiting, and weight loss. Esophagogastroduodenoscopy showed diffuse nodular lesions (size varying from 2 to 5 mm or more) of varying grades (mean score ± 1SD 2.70 ± 0.84) involving postbulbar duodenum. Video capsule endoscopies revealed nodular disease exclusively limited to duodenum. None of the patients had immunoglobulin deficiency or small intestine bacterial overgrowth or positive IgA endomysial antibodies. All patients were infected with Helicobacter pylori infection. Sequential antibiotic therapy eradicated Helicobacter pylori infection in 26 patients. Follow up duodenoscopies in these patients showed significant reduction of duodenal nodular lesions score (2.69 ± 0.79 to 1.50 ± 1.10; p < 0.001). Nodular lesions showed complete resolution in 5 patients and significant resolution in remaining 21 patients. Patients with resistant Helicobacter pylori infection showed no significant reduction of nodular lesions score (2.71 ± 0.96 to 2.64 ± 1.15; p = 0.58). Nodules partially regressed in score in 2 patients, showed no interval change in 10 patients and progressed in 2 patients.Conclusions: We report on a large cohort of patients with DDNLH, etiologically related to Helicobacter pylori infection. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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