Anemia and Ulcerative Jejunoileitis in a Child

Text A 7-year-old female patient was referred to our department for double balloon enteroscopy (DBE). At age 5 she was diagnosed with Crohn’s disease based on failure to thrive, iron-deficiency anemia and capsule endoscopy showing small bowel ulcers. Steroids did not result in clinical improvement. She had recurrent episodes of otitis media. After being non-responsive to azathipoprine she was sent for DBE. We found nodular lymphoid hyperplasia and aphtous ulcers in the ileum. Histology showed lack of plasma cells, NLH and increased intraepithelial lymphocytes. Serum immunoglobulins were low, confirming common variable immunodeficiency. The patient responded to the therapy with intravenous immunoglobulins.