Nodular lymphoid hyperplasia and histologic changes mimicking celiac disease, collagenous sprue, and lymphocytic colitis in a patient with selective IgA deficiency.
Selective IgA deficiency is the most common primary immunoglobulin deficiency. The clinical manifestations of selective IgA deficiency, including gastrointestinal (GI) complications, are rare and typically milder than those seen with common variable immunodeficiency or X-linked agammaglobulinemia. We present a rare case of selective IgA deficiency that shows a number of interesting histological features in the GI tract, including diffuse nodular lymphoid hyperplasia involving the entire small and large intestine, celiac disease-like and collagenous sprue-like changes in the small intestine, as well as lymphocytic colitis pattern. However, this patient had no particular GI symptoms suggestive of celiac sprue or microscopic colitis. These findings suggest that the GI tract in patients with selective IgA deficiency can show peculiar histologic changes that mimic celiac disease, collagenous sprue, or lymphocytic colitis, which may be a pattern of injury related to infection or immunoglobulin immunodeficiency-associated autoimmune phenomena.
Joo
Mee
M
Department of Pathology, Inje University Ilsan Paik Hospital, 2240 Daewha-dong, Ilsanseo-gu, Goyang-si, Gyeonggi-do 411-706, Republic of Korea. mjoo@paik.ac.kr
Shim
Sang Hwa
SH
Chang
Sun Hee
SH
Kim
Hanseong
H
Chi
Je G
JG
Kim
Nam Hoon
NH
D000328:Adult; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology; D046730:Colitis, Lymphocytic / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D006965:Hyperplasia; D017098:IgA Deficiency / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D007413:Intestinal Mucosa / Q000473:pathology; D007422:Intestines / Q000473:pathology*; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000473:pathology