Immunodeficiency and intestines - Diseases of digestive organs at children
Page 38 of 73 IMMUNODEFICIENCY AND INTESTINES
Gastrointestinal symptoms are often observed at children with immunodeficiency, but intestines dysfunction mechanisms remain not clear with such patients. One patients are predisposed to infection with lyambliya; other patients with the expressed functional or morphological changes of intestines have no strong indications of intestinal infection. It is possible to assume, however, that disturbance of resistance of an organism to intestinal microflora is the cornerstone of dysfunction of intestines. The diagnostic assessment of a condition of such patients is complicated by the fact that some intestinal infections can cause secondary immunodeficiences a consequence of considerable losses with a stake of immunoglobulins and lymphocytes.
The inborn pangipogammaglobulinemiya linked to a floor. Slight periodic diarrhea develops soon noqre of the birth and usually passes at children 2 years are more senior. On its background / the lambliasis rather often develops. In bioptata from a rectum abscesses of crypts are visible, however clinical signs of colitis are observed seldom.
Hypogammaglobulinemia. At these acquired frustration diarrhea arises more often and proceeds heavier, than at inborn pathology. Among patients of the advanced children's age about 50% have diarrhea and at many of them the steatorrhea is noted. In some cases focal dystrophy of fibers of a jejunum is observed, but at the same time the expressed disakharidazny insufficiency can proceed without noticeable structural disturbances. At X-ray inspection or a biopsy of a mucous membrane find a nodular lymphoid hyperplasia which clinically is not shown in any way.
The isolated insufficiency of IgA. This most widespread primary immunodeficiency seldom causes intestinal frustration. However patients with the isolated insufficiency have IgA more often than among the population in general, there are a lambliasis, an illness Krone, nonspecific ulcer colitis and a Gee's disease. The nature of such dependence is not clear.
Heavy combined immunodeficience (Swiss type). The heavy diarrhea and deep disturbances of absorption arising soon after the birth are one of the reasons of high mortality of such patients. The disease is characterized by deficit of disaccharidases, a focal atrophy of fibers of a small bowel and presence of PAS positive macrophages in own plate. In intestines of such patients within many months can persistirovat many microorganisms, for example rotaviruses.
Chronic granulomatosis. At the same time linked with a hollow disease in granulomas of intestines find multinuclear huge, cells and histiocytes with the increased maintenance of lipids in cytoplasm. Clinically the illness is shown by diarrhea, malabsorption, disturbance of passability of intestines.