[CIS PIDD] [cis-pidd] XLA and colitis

[CIS-PIDD]

I would like some advice about a 4y 3m boy with XLA who has been maintained
on IGSC since one month of age. He has a 15 month history of diarrhea that
has had some improvement on a dairy free diet and probiotic prescribed by
GI. He is growing and generally doing well clinically although his stools
are not normal. Initially, the fecal calprotectin was >2000 (ULN 162). Most
recently, the calprotectin was 1387.

EGD was normal.

Ileum/colon biopsy showed:

Mild ideal intraepithelial lymphocytosis, including vilous tips, with
preservation of the vilous architecture. This finding is likely related to
this patient's lymphocytic colitis. Nevertheless, similar findings have
been described in a wide variety of conditions, particularly celiac sprue
(not observed in the duodenal specimen) and non-steroidal anti-inflammatory
drug use.

Colon biopsies showed intraepithelial lymphocytosis within crypts and
surface epithelium, surface epithelial degeneration, and an increased
lamina propria lymphoplasmacytic infiltrate. There is no significant
increase in subepithelial collagen.

Suggestions?

Thank you,
Richard
-- 
Richard L. Wasserman, MD, PhD
Allergy Partners of North Texas
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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