Percorsi clinici
Un adolescente con dolore addominale e diarrea
Non sempre e solo MICI, sino a prova contraria
AN ADOLESCENT WITH ACUTE ABDOMINAL PAIN AND DIARRHOEA: A CASE OF GASTRO-INTESTINAL NODULAR LYMPHOID HYPERPLASIA
FEDERICO MARCHETTI, PATRIZIA SALIERNO, STEFANO MARTELOSSI*, VINCENZO VILLANACCI**, ALESSANDRO VENTURA
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
*Servizio di Gastroenterologia Pediatrica, IRCCS “Burlo Garofolo”, Trieste
**Dipartimento di II Patologia Chirurgica, Spedali Civili, Brescia
Novembre 2006 - pagg. 588 -591
Abstract
Gastro-intestinal nodular lymphoid hyperplasia is a deposit of B lymphocytes which gives a typical endoscopical and histological aspect. It can occur in different tracts of the gastro-intestinal system (stomach, ileum, colon and rectum). It is a non-specific inflammatory response which may be associated with either an immune deficiency or an intestinal infection mainly
due to Giardia and Helicobacter, or with an intolerance to milk proteins or celiac disease. It is a benign inflammation which tends to resolve spontaneously. There is no specific treatment except for the treatment of the associated disease or for symptomatic therapies.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
• Bellanti JA, Zeligs BJ, Malka-Rais J, Sabra
A. Abnormalities of Th1 function in non-IgE
food allergy, celiac disease, and ileal lymphonodular
hyperplasia: a new relationship? Ann
Allergy Asthma Immunol 2003;90(6, Suppl 3):
84-9.
• Bastlein C, Burlefinger R, Holzberg E, Voeth C, Garbrecht M, Ottenjann R. Common variable immunodeficiency syndrome and nodular lymphoid hyperplasia in the small intestine. Endoscopy 1988;20(5):272-5.
• Canto J, Arista J, Hernandez J. Nodular lymphoid hyperplasia of the intestine. Clinicopathologic characteristics in 11 cases. Rev Invest Clin 1990;42:198-203.
• Castaneda-Romero B, Diaz-Caldelas L, Galvan- Guerra E, et al. Intestinal lymphoid nodular hyperplasia in a patient with acquired dysgammaglobulinemia, chronic diarrhoea and bacterial overgrowth syndrome. Rev Gastroenterol Mex 1993;58:225-8.
• Colon AR, DiPalma JS, Leftridge CA. Intestinal lymphoid hyperplasia of childhood: patterns of presentation. J Clin Gastroenterol 1991;13:163-6.
• Kokkonen J, Tikkanen S, Karttunen TJ, Savilahti E. A similar high level of immunoglobulin A and immunoglobulin G class milk antibodies and increment of local lymphoid tissue on the duodenal mucosa in subjects with cow’s milk allergy and recurrent abdominal pains. Pediatr Allergy Immunol 2002;13(2): 129-36.
• Kokkonen J, Karttunen TJ. Lymphonodular hyperplasia on the mucosa of the lower gastrointestinal tract in children: an indication of enhanced immune response? J Pediatr Gastroenterol Nutr 2002;34(1):42-6.
• Morini S, Lorenzetti R, Stella F, Martini MT, Hassan C, Zullo A. Retrograde ileoscopy in chronic nonbloody diarrhea: a prospective, case- control study. Am J Gastroenterol 2003;98 (7):1512-5.
• Mukhopadhyay S, Harlor T, Floyd FD, Sidhu JS. Polypoid nodular lymphoid hyperplasia of the terminal ileum. Arch Pathol Lab Med 2004;20:1186-7.
• Ranchod M, Lewin KJ, Dorfman RF. Lymphoid hyperplasia of the gastrointestinal tract. A study of 26 cases and review of the literature. Am J Surg Pathol 1978;2:383-400.
• Riddell RH, Pathobiology of Helicobacter pylori infection in children. Can J Gastroenterol 1999;13:599-603.
• Rittmeyer C, Nakayama D, Ulshen MH. Lymphoid hyperplasia causing recurrent rectal prolapse. J Pediatr 1997;131(3):487-8.
• Shteyer E, Koplewitz BZ, Gross E, Granot E. Medical treatment of recurrent intussusception associated with intestinal lymphoid hyperplasia. Pediatrics 2003;111(3):682-5.
• Turunen S, Karttunen TJ, Kokkonen J. Lymphoid nodular hyperplasia and cow’s milk hypersensitivity in children with chronic constipation. J Pediatr 2004;145:606-11.
• Bastlein C, Burlefinger R, Holzberg E, Voeth C, Garbrecht M, Ottenjann R. Common variable immunodeficiency syndrome and nodular lymphoid hyperplasia in the small intestine. Endoscopy 1988;20(5):272-5.
• Canto J, Arista J, Hernandez J. Nodular lymphoid hyperplasia of the intestine. Clinicopathologic characteristics in 11 cases. Rev Invest Clin 1990;42:198-203.
• Castaneda-Romero B, Diaz-Caldelas L, Galvan- Guerra E, et al. Intestinal lymphoid nodular hyperplasia in a patient with acquired dysgammaglobulinemia, chronic diarrhoea and bacterial overgrowth syndrome. Rev Gastroenterol Mex 1993;58:225-8.
• Colon AR, DiPalma JS, Leftridge CA. Intestinal lymphoid hyperplasia of childhood: patterns of presentation. J Clin Gastroenterol 1991;13:163-6.
• Kokkonen J, Tikkanen S, Karttunen TJ, Savilahti E. A similar high level of immunoglobulin A and immunoglobulin G class milk antibodies and increment of local lymphoid tissue on the duodenal mucosa in subjects with cow’s milk allergy and recurrent abdominal pains. Pediatr Allergy Immunol 2002;13(2): 129-36.
• Kokkonen J, Karttunen TJ. Lymphonodular hyperplasia on the mucosa of the lower gastrointestinal tract in children: an indication of enhanced immune response? J Pediatr Gastroenterol Nutr 2002;34(1):42-6.
• Morini S, Lorenzetti R, Stella F, Martini MT, Hassan C, Zullo A. Retrograde ileoscopy in chronic nonbloody diarrhea: a prospective, case- control study. Am J Gastroenterol 2003;98 (7):1512-5.
• Mukhopadhyay S, Harlor T, Floyd FD, Sidhu JS. Polypoid nodular lymphoid hyperplasia of the terminal ileum. Arch Pathol Lab Med 2004;20:1186-7.
• Ranchod M, Lewin KJ, Dorfman RF. Lymphoid hyperplasia of the gastrointestinal tract. A study of 26 cases and review of the literature. Am J Surg Pathol 1978;2:383-400.
• Riddell RH, Pathobiology of Helicobacter pylori infection in children. Can J Gastroenterol 1999;13:599-603.
• Rittmeyer C, Nakayama D, Ulshen MH. Lymphoid hyperplasia causing recurrent rectal prolapse. J Pediatr 1997;131(3):487-8.
• Shteyer E, Koplewitz BZ, Gross E, Granot E. Medical treatment of recurrent intussusception associated with intestinal lymphoid hyperplasia. Pediatrics 2003;111(3):682-5.
• Turunen S, Karttunen TJ, Kokkonen J. Lymphoid nodular hyperplasia and cow’s milk hypersensitivity in children with chronic constipation. J Pediatr 2004;145:606-11.
Corrispondenza: marchetti@burlo.trieste.it
