Bejaoui M, Guezmir M, Hamdi M, Mezni F, Gorbel A, Lakhoua R
Service de Pédiatrie, Hôpital Charles Nicolle, Tunis, Tunisie.
Ann Pediatr (Paris). 1992 Jun;39(6):359-64.
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.
报告了15例年龄在17个月至15岁之间的肠道结节性淋巴组织增生（NLH）患者。14例患者的NLH局限于小肠，1例同时累及小肠和结肠。诊断时的平均年龄为10岁。最常见的首发症状是肠道表现（86%）。1例通过X线检查怀疑诊断，10例通过消化内镜检查怀疑诊断。所有15例患者均获得组织学确诊。对8例患者进行了免疫组织化学研究，1例免疫缺陷患者显示IgA浆细胞数量稀少，其他7例患者为多克隆浆细胞群体，主要为IgA浆细胞。5例患者存在体液免疫缺陷，3例患者有不同程度的低丙种球蛋白血症，2例患者有IgA缺乏；8例患者发现肠道贾第虫病。记录了5例患者的组织学转归；仅1例患者的NLH证据消失。在大多数情况下，甲硝唑改善了临床症状。
