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Hypogammaglobulinemia With Nodular Lymphoid Hyperplasia of the Small Bowel
Charles H. Kirkpatrick, MD;
David Waxman, MD;
Othello D. Smith, MD;
R. Neil Schimke, MD
Arch Intern Med. 1968;121(3):273-277.
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Gastrointestinal symptoms occur frequently in patients with hypogammaglobulinemia. Rosen and Janeway reported that more than half of the patients with acquired hypogammaglobulinemia had diarrhea or steatorrhea.1 In contrast, these symptoms occurred rarely in patients with the congenital form of hypogammaglobulinemia. The histology of the small intestine usually has been normal although a spruelike pattern has been noted occasionally. Recently, a syndrome of chronic diarrhea and dysgammaglobulinemia associated with numerous hyperplastic lymphoid nodules in the submucosa of the small bowel has been described.2
We have recently had an opportunity to study an additional example of this disorder and to characterize further the nature of the immunological defect. In the present case, the principal gastrointestinal symptom was bleeding and there was no evidence of malabsorption. The patient had severe hypogammaglobulinemia involving all three major immunoglobulins, without any demonstrable defect in the processes of cellular immunity.
Patient Summary
A 26-year-old white
. . . [Full Text PDF of this Article]
Author Affiliations
Kansas City, Kan
From the departments of medicine (Drs. Kirkpatrick, Waxman, and Schimke) and pathology, (Dr. Smith), and the Clinical Research Center, Kansas University Medical Center, Kansas City, Kan.
Footnotes
Received for publication Sept 13, 1967; accepted Oct 27.
Reprint requests to the Department of Medicine, Kansas University Medical Center, Rainbow Blvd at 39th St, Kansas City, Kan 66103 (Dr. Kirkpatrick).
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