Innumerable nodules in all parts of the small intestine

Clinical presentation A 46-year-old woman, with a medical history of recurrent urinary tract infections, was admitted to our hospital because of repeated episodes of nausea and vomiting for the last 3 years. Alarm symptoms were absent and physical examination was unremarkable. Upper gastrointestinal endoscopy revealed numerous small nodular lesions (measuring 1–5 mm in diameter) throughout the entire duodenum (figure 1). The stomach was not involved. Extensive biopsies from the nodules were obtained during the procedure (figure 2). Stool antigen test for Helicobacter pylori infection was negative. Laboratory examination showed reduction of IgG and IgA: 3.4 g/L (7.0–16.0), respectively, 0.21 g/L (0.7–4.0). IgM was normal: 1.24 g/L (0.4–2.3). HIV infection serology was negative. Thoracic and abdominal CT scan was normal. Additional capsule endoscopy, double-balloon enteroscopy using the oral route and colonoscopy were performed and revealed innumerable similar nodules in all parts of the small intestine (figure 3)....

Source: Gut - August 7, 2023 Category: Gastroenterology Authors: Veghel, J. v., Zwam, P. v., Schreuder, R.-M. Tags: GUT Snapshot, Gut Editor ' s quiz: GI snapshot Source Type: research