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Innumerable nodules in all parts of the small intestine
  1. Jara van Veghel1,
  2. Peter van Zwam2,
  3. Ramon-Michel Schreuder1
  1. 1Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, The Netherlands
  2. 2Department of Pathology, Eurofins PAMM laboratory for pathology and medical microbiology, Eindhoven, The Netherlands
  1. Correspondence to Drs Jara van Veghel, Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, North Brabant, The Netherlands; jara.v.veghel{at}catharinaziekenhuis.nl

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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 …

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.