Immunoproliferative Erkrankung des Dünndarms: Eine seltene Differentialdiagnose des M. Crohn

Abstract

For 2 years a 39-year-old Turkish man had had abdominal pain as well as weight loss of more than 10 kg over 4 months, associated with a raised ESR (33 mm/h) and recurrent gastrointestinal bleedings which endoscopy revealed to have been caused by a marked erosive duodenitis. Biopsies from the duodenum and terminal ileum demonstrated lymphoplasmocytic infiltration of the entire small intestine in the sense of immunoproliferative small intestinal disease (IPSID). By immunohistochemistry the lymphoplasmacellular infiltrate showed polyclonal expression of IgA without IgA increase in serum, urine and duodenal juice. The patient was treated with tetracycline (500 mg twice daily) for one year. The symptoms and histological lesions were much improved after 4 months. One year after diagnosis he was symptom-free.

Evaluating Lymphoma Risk in Inflammatory Bowel Disease

“…Medline cited publications regarding lymphoma risk in IBD patients since 1950. McCullough et al, 1992, Pohl et al, 1991, Bartram and Chrispin, 1973 and ulcerative colitis (Isomoto et al, 2003, Luo et al, 1997, Wagonfeld et al, 1976, Myerson et al, 1974, Parnes et al, 1974, Friedman et al, 1968, Federman et al, 1963. Clearly, lymphoma of the GI tract frequently occurs in the absence of inflammatory bowel disease.…”