We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Hypogammaglobulinemia With Nodular Lymphoid Hyperplasia of the Small Bowel

Charles H. Kirkpatrick, MD; David Waxman, MD; Othello D. Smith, MD; R. Neil Schimke, MD
Arch Intern Med. 1968;121(3):273-277. doi:10.1001/archinte.1968.03640030065011.
Text Size: A A A
Published online


Gastrointestinal symptoms occur frequently in patients with hypogammaglobulinemia. Rosen and Janeway reported that more than half of the patients with acquired hypogammaglobulinemia had diarrhea or steatorrhea.1 In contrast, these symptoms occurred rarely in patients with the congenital form of hypogammaglobulinemia. The histology of the small intestine usually has been normal although a spruelike pattern has been noted occasionally. Recently, a syndrome of chronic diarrhea and dysgammaglobulinemia associated with numerous hyperplastic lymphoid nodules in the submucosa of the small bowel has been described.2

We have recently had an opportunity to study an additional example of this disorder and to characterize further the nature of the immunological defect. In the present case, the principal gastrointestinal symptom was bleeding and there was no evidence of malabsorption. The patient had severe hypogammaglobulinemia involving all three major immunoglobulins, without any demonstrable defect in the processes of cellular immunity.

Patient Summary  A 26-year-old white


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.