Lymphatics in the Alimentary Tract of Children in Health and Disease: Study on Mucosal Biopsies Using the Monoclonal Antibody D2-40

2005 ◽  
Vol 8 (5) ◽  
pp. 541-549 ◽  
Author(s):  
Yiping Zeng ◽  
Fenghua Wang ◽  
Elizabeth D. Williams ◽  
Chung Wo Chow
Keyword(s):  
Clinical Features ◽  
Alimentary Tract ◽  
Lymphatic Vessels ◽  
Specific Method ◽  
Intestinal Lymphangiectasia ◽  
Histologic Diagnosis ◽  
Protein Losing Enteropathy ◽  
Negative Finding ◽  
Young Infants ◽  
Disease Study

Primary intestinal lymphangiectasia and intestinal lymphatic hypoplasia are 2 causes of protein-losing enteropathy in children and share many common clinical features. For the diagnosis of lymphatic hypoplasia on endoscopic biopsies of the intestine, i.e., based on a negative finding in a small specimen, a very sensitive and specific method for identifying lymphatics is essential. In the present study, lymphatic vessels were labelled using D2-40 immunostaining in mucosal biopsy specimens of the alimentary tract of children in whom no histologic abnormality was noted and of those who had different relatively common pediatric conditions, including inflammatory and neoplastic diseases. Using this method, lymphatic vessels were well visualized even in young infants and not destroyed by diseases. The presence of the muscularis mucosae in specimens was important for adequate assessment. In the duodenum and esophagus, lymphatics were observed in every single section; in the stomach, ileum, and colon, they were less regular and several sections were sometimes required. The extreme sensitivity of this method for demonstrating lymphatic vessels in the duodenum makes it ideal for the histologic diagnosis of intestinal lymphatic hypoplasia. In 4 patients who were considered to have this diagnosis based on clinical features, full-thickness intestinal biopsies and electron microscopy, D2-40 immunostaining confirmed the absence or marked paucity of lymphatics.

scholarly journals Congenital intestinal lymphangiectasia

2011 ◽  
Vol 68 (3) ◽  
pp. 270-273
Author(s):  
Dusan Popovic ◽  
Milan Spuran ◽  
Tamara Alempijevic ◽  
Miodrag Krstic ◽  
Srdjan Djuranovic ◽  
...  
Keyword(s):  
Early Recognition ◽  
Clinical Manifestations ◽  
Lymphatic Vessels ◽  
High Protein Diet ◽  
Intestinal Wall ◽  
Intestinal Biopsy ◽  
Intestinal Lymphangiectasia ◽  
Laboratory Assessment ◽  
Protein Losing Enteropathy ◽  
Adequate Treatment

Background. Congenital intestinal lymphangiectasia is a disease which leads to protein losing enteropathy. Tortous, dilated lymphatic vessels in the intestinal wall and mesenterium are typical features of the disease. Clinical manifestations include malabsorption, diarrhea, steatorrhea, edema and effusions. Specific diet and medication are required for disease control. Case report. A 19-year old male patient was hospitalized due to diarrhea, abdominal swelling, weariness and fatigue. Physical examination revealed growth impairment, ascites, and lymphedema of the right hand and forearm. Laboratory assessment indicated iron deficiency anaemia, lymphopenia, malabsorption, inflammatory syndrome, and urinary infection. Enteroscopy and video capsule endoscopy demonstrated dilated lymphatic vessels in the small intestine. The diagnosis was confirmed by intestinal biopsy. The patient was put on high-protein diet containing medium-chain fatty acids, somatotropin and suportive therapy. Conclusion. Congenital intestinal lymphangiectasia is a rare disease, usually diagnosed in childhood. Early recognition of the disease and adequate treatment can prevent development of various complications.

scholarly journals Gastrointestinal Cryptococcosis Associated with Intestinal Lymphangiectasia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fernando Naranjo-Saltos ◽  
Alejandro Hallo ◽  
Carlos Hallo ◽  
Andres Mayancela ◽  
Alejandra Rojas
Keyword(s):  
Opportunistic Infections ◽  
Lymphatic Vessels ◽  
Immunocompetent Patient ◽  
Intestinal Lumen ◽  
Histopathological Study ◽  
Intestinal Lymphangiectasia ◽  
Protein Losing Enteropathy ◽  
Unusual Association ◽  
Intestinal Involvement ◽  
Cellular Components

Intestinal lymphangiectasia is a pathological dilation of enteric lymphatic vessels resulting in lymph leakage to the intestinal lumen. This chronic lymph leakage leads to a state of immunosuppression secondary to the loss of humoral and cellular components of the immune system and represents a potential risk factor for opportunistic infections. We report a case of protein-losing enteropathy in a seemingly immunocompetent patient. An intestinal histopathological study revealed the unusual association of lymphangiectasia and intestinal cryptococcosis. Although cryptococcal infection is common in immunocompromised patients, intestinal involvement is rarely reported. We found no reports on the association of intestinal cryptococcosis in patients with lymphangiectasia. This case report is the first to describe intestinal cryptococcosis associated with intestinal lymphangiectasia.

INTRAPERICARDIAL TERATOMA: A CAUSE OF ACUTE PERICARDIAL EFFUSION IN INFANCY

PEDIATRICS ◽  
1969 ◽  
Vol 43 (1) ◽  
pp. 71-78
Author(s):  
James L. Reynolds ◽  
John K. Donahue ◽  
Charles W. Pearce
Keyword(s):  
Pericardial Effusion ◽  
Clinical Features ◽  
Personal Experience ◽  
Young Infant ◽  
Early Infancy ◽  
Cardiac Tumors ◽  
Young Infants

On the basis of personal experience with two patients and a review of the 35 previously reported cases, we described the pathologic and clinical features of intrapericardial teratoma. This tumor is single, large, encapsulated, multicystic, and pedunculated. It is attached by a short fibrous stalk or pedicle to the adventitia of one or both great arteries. Only 2 of the 37 intrapericardial teratomas were malignant. The tumor is found predominantly in children, usually during early infancy, and among cardiac tumors of childhood it is second only to rhabdomyoma in frequency. Acute or chronic pericardial effusion commonly accompanies the teratoma. All young infants reported have had acute pericardial effusion with tamponade. Typically, the associated fluid is serous, sterile, copious, and recurrent; it usually obscures the presence of the tumor. Intrapericardial teratoma is a likely diagnosis in any young infant having such penicardial effusion; other cardiac tumors do not have these clinical features. Artificial pneumopericardium will demonstrate the teratoma, and operation is curative if the tumor is benign. Uncontrollable bleeding from the aorta on dissection of the tumor stalk has been an operative hazard; but, if anticipated, it can be avoided.

O80 Primary intestinal lymphangiectasia: clinical features and follow up. About 8 cases

2003 ◽  
Vol 14 ◽  
pp. S23
Author(s):  
F. Badet ◽  
F. Joly ◽  
B. Flourié ◽  
M. Gérard-Boncompain ◽  
B. Bonnotte ◽  
...  
Keyword(s):  
Clinical Features ◽  
Intestinal Lymphangiectasia

scholarly journals Resolution of longstanding protein-losing enteropathy in a patient with intestinal lymphangiectasia after treatment for malignant lymphoma

1981 ◽  
Vol 80 (1) ◽  
pp. 166-168 ◽  
Author(s):  
Samuel Broder ◽  
Thomas R. Callihan ◽  
Elaine S. Jaffe ◽  
Vincent T. DeVita ◽  
Warren Strober ◽  
...  
Keyword(s):  
Malignant Lymphoma ◽  
Intestinal Lymphangiectasia ◽  
Protein Losing Enteropathy

A Case of Protein-Losing Enteropathy Caused by Intestinal Lymphangiectasia in a Preterm Infant

PEDIATRICS ◽  
2001 ◽  
Vol 107 (2) ◽  
pp. 416-417 ◽  
Author(s):  
G. Salvia ◽  
C. F. Cascioli ◽  
F. Ciccimarra ◽  
G. Terrin ◽  
S. Cucchiara
Keyword(s):  
Preterm Infant ◽  
Intestinal Lymphangiectasia ◽  
Protein Losing Enteropathy

scholarly journals Virology, Clinical Features and Diagnosis of COVID 19: Review Analysis

2020 ◽  
Vol 18 (2) ◽  
pp. 75-79
Author(s):  
L. Bhusal ◽  
K. Amgain ◽  
G. Dangal ◽  
P.D. Tamang ◽  
P. Shahi ◽  
...  
Keyword(s):  
Viral Load ◽  
Human Resources ◽  
Clinical Features ◽  
Point Of Care ◽  
Virus Transmission ◽  
Rapid Test ◽  
Disease Diagnosis ◽  
Test Method ◽  
Specific Method ◽  
The World

COVID-19 requires unprecedented mobilization of the health systems to prevent the rapid spread of this unique virus, which spreads via respiratory droplet and causes respiratory disease. There is an urgent need for an accurate and rapid test method to quickly identify many infected patients and asymptomatic carriers to prevent virus transmission and assure timely treatment of the patients. This article aims as an outcome of review of the evidence on viral load and its virulence of SARS-CoV2, so that it will help in further understanding the fact useful for investigating and managing the COVID-19 cases. A search of available evidence was conducted in pub-med “COVID-19 viral load and virulence” and its associated characters world-wide and Google Scholar to capture the most recently published articles. The WHO and Centre for Disease Control and Prevention (CDC) database of publications on novel coronavirus were also screened for relevant publications. Abstracts of 55 articles were screened by two authors and 15 were included in this study based on the inclusion criteria. SARS-coV2, the causative agent of COVID-19 falls under the coronavirus family but it has higher infectivity compared to SARS and MERS with higher reproduction numbers (Ro). Virulence has been found to be different throughout the world, however lower compared to SARS and MERS, till date. The most common clinical features have been found to be cough and fever. RT PCR remains the most sensitive and specific method for the diagnosis of COVID-19 although it is time consuming, costly and requires highly skilled human resources. Hence, newer modalities like RT- LAMP can be alternative for point of care diagnosis as this is both cost effective and requires less skilled human resources. Despite recent advances in disease diagnosis and treatment outcomes using latest technological advances in molecular biology, the global pandemic COVID-19 remains a major headache for governments across the world due to limited testing capacity and lack of appropriate treatment and vaccine.

scholarly journals Primary intestinal lymphangiectasia in adults - diagnostic and therapeutic challenge

2018 ◽  
Vol 75 (1) ◽  
pp. 95-99
Author(s):  
Tatiana Jocic ◽  
Olgica Latinovic-Bosnjak ◽  
Mirjana Zivojinov ◽  
Mirjana Stojsic ◽  
Jelena Ilic-Sabo
Keyword(s):  
Small Intestine ◽  
Celiac Disease ◽  
Plasma Proteins ◽  
Histological Analysis ◽  
Inflammatory Diseases ◽  
Lymphatic Vessels ◽  
Intestinal Lymphangiectasia ◽  
Double Balloon Enteroscopy ◽  
Endoscopy Capsule ◽  
Secondary Causes

Introduction. Primary intestinal lymphangiectasia is a rare disorder, characterized by abnormal dilation of intestinal lymphatic vessels and extensive enteric loss of lymph rich in plasma proteins, lymphocytes and chylomicrons. The main characteristics of the disease are hypoalbuminemia, hypogammaglobulinemia, lymphocytopenia, and more rarely, the deficit of liposoluble vitamins and anemia. Except for primary, there are secondary lymphangiectasia, associated with celiac disease, malignant, infective and inflammatory diseases of the small intestine, fibrosis, liver and cardiovascular diseases. Case report. A male, 33 years of age, presented for his medical examination suffering from diarrhea and edema. The diagnosis was established upon the histological examination of a small intestine biopsy during double balloon enteroscopy, which revealed changes only in one segment of the intestine examined. Such a finding was later confirmed by the video endoscopy capsule. Conclusion. The diagnosis of intestinal lymphangiectasia is usually established before the age of 3, but it can also be diagnosed in adults. The diagnosis is based on the histological analysis of the intestinal mucosa biopsy, obtained by endoscopic procedures. The diagnosis of primary intestinal lymphangiectasia is also made upon the exclusion of secondary causes.

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