Related Experiment Videos
[Lymphoid hyperplasia of the intestine in children. 15 cases]
Insights
Nodular lymphoid hyperplasia (NLH) in children often presents with intestinal issues. While metronidazole can help symptoms, NLH frequently persists, especially in those with immune deficiencies.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Gastrointestinal Pathology
Context:
- Nodular lymphoid hyperplasia (NLH) is a recognized condition affecting the gastrointestinal tract.
- Understanding its presentation, associated conditions, and outcomes in pediatric populations is crucial for effective management.
- This study focuses on a cohort of pediatric patients diagnosed with NLH.
Purpose:
- To report on a series of pediatric cases of nodular lymphoid hyperplasia (NLH).
- To detail the clinical presentation, diagnostic methods, and associated immunological findings.
- To evaluate the long-term histological outcomes and the efficacy of metronidazole treatment.
Summary:
- Fifteen pediatric patients (17 months to 15 years) with intestinal NLH were analyzed.
- The majority presented with gastrointestinal symptoms, with diagnosis aided by imaging and endoscopy.
- Immunohistochemistry revealed immune deficiencies in some, notably IgA deficiency and hypogammaglobulinemia, often co-occurring with giardiasis.
Impact:
- Highlights the association between NLH, humoral immune deficiencies, and giardiasis in children.
- Suggests that while metronidazole may alleviate symptoms, NLH resolution is uncommon, particularly in immunocompromised individuals.
- Provides insights into the diagnostic and therapeutic challenges of pediatric NLH.
Abstract:
Fifteen cases of nodular lymphoid hyperplasia (NLH) of the bowel in patients aged 17 months to 15 years are reported. Fourteen patients had NLH confined to the small bowel and one had involvement of both the small bowel and colon. Mean age at diagnosis was 10 years. The most common presenting symptoms were intestinal manifestations (86%). Diagnosis was suspected upon roentgenographic studies in one case and digestive endoscopy in ten cases. Histologic confirmation was obtained in all fifteen patients. Immunohistochemical studies, done in 8 patients, demonstrated a paucity of IgA plasmocytes in one patient with an immune deficiency and a polyclonal plasmocyte population with mainly IgA plasmocytes in the seven other patients. Five patients had a deficiency in humoral immunity, with variable expression hypogammaglobulinemia in three patients and IgA deficiency in two; intestinal giardiasis was found in eight patients. Histologic outcome was documented in five cases; evidence of NLH disappeared in only one patient. Metronidazole improved clinical symptoms in most instances.