Diffuse Duodenal Nodular Lymphoid Hyperplasia. Duodenal composite images showing effect of H. pylori eradication. 25 year woman presented with recurrent epigastric pain, vomiting and weight loss of 10 kg over past 2 years. Immunoglobulin levels were within normal limits [IgG 1460 mg/dl (normal 700-1600 mg/dl); IgM. 190 mg/dl (normal = 40-230 mg/dl); IgA 230 mg/dl (normal = 70-400 mg/dl)]. Patient had H. pylori infection with severe fundic exudative gastritis. Top 2 images: Second part of duodenum was carpeted with numerous nodular lesions 3 to 5 mm in size, scored as grade 3 nodular disease. Patient received H. pylori sequential therapy and 14C UBT 6 weeks after therapy showed eradication of infection. Bottom 2 images. Follow up duodenoscopic images at one year showed near complete resolution of the nodular lesions (scored as grade 0). Repeat duodenal biopsies failed to show nodular lymphoid follicles.