[Radiologic digestive manifestations in patients with antibody deficiency]

In order to establish a relationship between radiological and clinical data and/or early diagnosis of the complications frequently found in patients with hypogammaglobulinemia, we carried out gastrointestinal series (GIS) in 47 patients mean age 22.5 years with hypogammaglobulinemia or primary antibody deficiencies.

15 patients did not show any radiological abnormalities. Nodular lymphoid hyperplasia (NLH) was found in 23 cases. None of the patients with NLH had gastrointestinal symptoms. Radiologic signs of malabsorption were present in 15 cases. 2 patients with radiologic signs of malabsorption (mean age 12 years) did have clinical or laboratory finding suggesting a malabsortive syndrome. Moreover, 2 patients showing clinical manifestations of malabsorption did not show any significant radiological findings. 4 patients were diagnosed of chronic atrophic gastritis (CAG) by means of endoscopy and gastric biopsy, whereas only in one of these cases GIS showed gastric fold atrophy, compatible with the pathologic diagnosis of CAG; 2 of these patients progressed to gastric cancer, a diagnosis that was done by endoscopy.

We have observed that NLH is more frequent in patients with hypogammaglobulinemia than in the normal population, it is asymptomatic and may be diagnosed by radiological methods. The radiological findings of malabsorption do not correlate with the clinical data. A combination of endoscopy and gastric biopsy is the method of choice for the early diagnosis of atrophic gastritis and gastric cancer, since the radiological alterations found in GIS appear at late times. We conclude that GIS supplies few data to the study of digestive manifestations in patients with hypogammaglobulinemia, except in the case of NLH.