IMMUNOPROLIFERATIVE SMALL-INTESTINAL DISE ASE - CASE-REPORT WITH IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL STUDIES

The clinico-pathological characteristics of a 22 years old mestizo mex ican patient with immunoproliferative small intestinal disease (IPSID) are described. The patient coursed with chronic diarrhea, malabsorpti on, and a 30 kg weight loss. The laboratory tests revealed hypokalemia , hypocalcemia, hypoalbuminemia and decreased levels of immunoglobulin s. The histological changes in the endoscopic biopsies included a dens e lymphoplasmacytic infiltrate in the lamina propria that produced vel losity blunting and distorsion of the crypts. The immunohistochemical analysis disclosed that almost every cell was positive to heavy chains and negative to light chains. The radiological studies showed thicken ing of the intestinal folds and mesenteric adenomegalies. In the full thicknes biopsy of the yeyunum, in addition to the lymphoplasmacytic i nfiltrate, a high grade malignant lymphoma infiltrating the regional l ymph nodes was documented. An ultrastructural study revealed viruses t hat resembled the morphology described for the Epstein-Barr virus. The main clinico-pathological findings of other eight mexican patients wi th IPSID previously reported are commented. It is concluded that the I PSID is a rare disease in our country but it can be found sporadically .