Şerif YILMAZ, Kadim BAYAN, Mehmet DURSUN, Fikri CANORUÇ

Kronik ishalden, immün yetmezlik tanısına: İntestinal noduler lenfoid hiperplazinin eşlik ettiği bir common variable immün yetmezlik olgusu

On yedi yaşında bayan bir hasta kronik ishal nedeniyle yatırıldı. Çocukluğundan beri tekrarlayan solunum yolları enfeksiyonları ve ishal atakları tanımlamaktaydı. Endoskopik bakıda düodenum mukozasında yaygın kümeleşmiş polipoid noduller vardı. Biyopsi örneği noduler lenfoid hiperplaziyi göstermekteydi. Common variable immün yetmezlik sendromundan şüphelenildi ve tanı, plazma gama-globulin düzeylerinin düşüklüğünün gösterilmesiyle doğrulandı. İmmünglobulin tedavisinin başlanması ndan sonra günlük ishal sayısı ve solunum yolları enfeksiyonlarının sıklığı ve şiddeti belirgin azaldı. Bu olgu ishalin altta yatan bir nedeni olarak Common variable immün yetmezlik sendromuna ve noduler lenfoid hiperplazi ile olan ilişkisine odaklanmaktadır.

Anahtar Kelimeler:

İshal, common variable immün yetmezlik

From chronic diarrhoea to diagnosis of immundeficiency: A case with common variable immunodeficiency accompanied by intestinal nodular lymphoid hyperplasia

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.

Keywords:

Diarrhea, common variable immunodeficiency,

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