Diffuse Nodular Lymphoid Hyperplasia of Intestine in selective IgG 2 subclass Deficiency, Autoimmune thyroiditis, and Autoimmune hemolytic Anemia: Case Report and Literature Review

Abstract

Diffuse Nodular Lymphoid Hyperplasia (DNLH) of the intestine is a rare lymphoproliferative disorder of uncertain etiology, which is characterized by the presence of multiple nodular lesions. It can present as an asymptomatic disease or manifest with gastrointestinal symptoms like abdominal pain, chronic diarrhea, occult bleeding or rarely intestinal obstruction. DNLH has been seen in association with common variable immunodeficiency (CVID) where it poses a risk of malignant transformation. We present a case of diffuse lymphoid nodular lymphoid hyperplasia in a patient who was presented with abdominal pain and diarrhea, and was later found to have IgG2 subclass immunodeficieny, autoimmune hemolytic anemia and Hashimoto's (autoimmune) thyroiditis. Through this report, we wish to review current literature as well as share our clinical experience in managing this rare entity.