Kronik ishalden, immün yetmezlik tanisina: Intestinal noduler lenfoid hiperplazinin eslik ettigi bir common variable immün yetmezlik olgusu
From chronic diarrhoea to diagnosis of immundeficiency: A case with common variable immunodeficiency accompanied by intestinal nodular lymphoid hyperplasia
- Ana Sayfa
- Sayılar
- Kronik ishalden, immün yetmezlik tanisina: Intestinal noduler lenfoid hiperplazinin eslik ettigi bir common variable immün yetmezlik olgusu...
Özet
On yedi yasinda bayan bir hasta kronik ishal nedeniyle yatirildi. Çocuklugundan beri tekrarlayan solunum yollari enfeksiyonlari ve ishal ataklari tanimlamaktaydi. Endoskopik bakida düodenum mukozasinda yaygin kümelesmis polipoid noduller vardi. Biyopsi örnegi noduler lenfoid hiperplaziyi göstermekteydi. Common variable immün yetmezlik sendromundan süphelenildi ve tani, plazma gama-globulin düzeylerinin düsüklügünün gösterilmesiyle dogrulandi. Immünglobulin tedavisinin baslanmasi ndan sonra günlük ishal sayisi ve solunum yollari enfeksiyonlarinin sikligi ve siddeti belirgin azaldi. Bu olgu ishalin altta yatan bir nedeni olarak Common variable immün yetmezlik sendromuna ve noduler lenfoid hiperplazi ile olan iliskisine odaklanmaktadir.
Abstract
A 17-year-old female patient was hospitalized for chronic diarrhea. Since childhood she had experienced recurrent episodes of respiratory tract infections and diarrhea. Endoscopic examination revealed diffuse clustered polypoid nodules in the duodenum. Biopsy specimen showed nodular lymphoid hyperplasia. Common variable immunodeficiency syndrome was suspected and diagnosis was established by demonstrating a significant reduction of plasma gamma-globulin levels. After starting immunoglobulin treatment, daily diarrhea count decreased, and both incidence and severity of respiratory tract infections were significantly reduced. This case report focuses on common variable immunodeficiency syndrome as a potential underlying cause of diarrhea, and the relationship with nodular lymphoid hyperplasia.
