The small bowel in immunoglobulin deficiency syndromes

Recent advances in immunology have permitted recognition of a group of patients who have gastrointestinal manifestations as part of an immunoglobulin deficiency syndrome. Such immunoglobulin deficiency may be primary or secondary to a variety of diseases. We have classified and described the small bowel roentgen features associated with the various immunoglobulin deficiency syndromes as follows: the sprue pattern, as seen in hypogammaglobulinemic sprue and in IgA-deficient sprue; multiple nodular defects; inflammatory changes secondary to giardiasis, associated with immune deficiency diseases; and thickening of the small intestinal folds, as seen in the plasma cell dyscrasias, lymphoma, intestinal lymphangiectasia, and amyloidosis.