Figure 5From: Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pyloriinfection Diffuse Duodenal Nodular Lymphoid Hyperplasia. Duodenal composite images. Progression of disease. 40 year women presented with epigastric pain, vomiting, weight loss and recurrent diarrhoea. IgA levels were elevated [IgG 1400 mg/dl (normal 700-1600 mg/dl); IgM. 220 mg/dl (normal = 40-230 mg/dl); IgA 540 mg/dl (normal = 70-400 mg/dl)]. Patient had H. pylori related erythematous antral gastritis. Patient received H. pylori eradication sequential therapy followed by Levofloxacin/Doxycycline based second line eradication therapy and 14C UBT showed resistant H. pylori infection. Top 2 images. Duodenal mucosa showed diffuse infiltration with nodules of 3 to 5 mm size, scored as grade 3 nodular disease. Bottom 2 images at 2 years follow up. There was significant increase in size (>5 mm) and density of the nodular lesions. Kerckring's folds showed infiltration and focal thickening by nodular disease, scored as grade 4 nodular disease. Biopsies showed nodular lymphoid follicles and infiltrate showed polyclonality of the lymphocytes.Back to article page