Intestinal lymphoid hyperplasia (ILH) is a rare reason of recurrent introversion in kids and youngchildren. Surgical treatment has been recommended to handle this intestinal disorder.
It is a mild condition in which lymph follicles present in the intestine develops and creates huge visible protrusions of the mucosa. It may be symptomless or may be linked with stomach pain, gastrointestinal hemorrhage, and infolding.
The cause of lymphoid hyperplasia is yet to be discovered. It has been believed that this occurs in association with bacterial, viral, or parasitic infections along with allergic reaction to various foods. In adults, compared to the children, it has been witnessed to unearth in association with immune system deficiencies viz., acquired idiopathic hypogammaglobulinemia or human immunodeficiency virus infection.
Radiologically, ILH has been surveyed as a part of a spectrum of diseases including lymphoma. Lymphoma is extremely rare under the age of 1 year.
There is no consensus in terms of handling of patients suffering with Intestinal Lymphoid Hyperplasia; some support the "watchful observation therapy" whereas others endorse surgicaltreatment.
Few patients are often treated with antihistamine, with clearance of symptoms in 14 to 21 days; a few of these patients, who are neutral and did not show any response, were treated with steroids in a month or two.
In majority of the children with the severe type of the appendix and the terminal ileum were found, appendectomy was advised, while in some of the children who suffered intussusception frequenlty, terminal ileal resection and right hemicolectomy were administered.
Steroid treatment for ILH is very common therapy. It had been recommended more than 50 years ago. Yet, it is quite astonishing that there is no mention of this therapeutic modality in latest pediatric or pediatric gastroenterology textbooks.
A recently published case report emphasized the part of steroid treatment in an infant with bloody stool, diarrhea, and severe intestinal nodular lymphoid hyperplasia. The methodology by which steroid treatment influences intestinal lymphoid hyperplasia is still uncertain.
In a recent study, it has been speculated that intestinal lymphoid hyperplasia can manifest a long-term upregulation of intestinal immunologic performance as a reaction to luminal food antigens.
If this is to be believed, a lymphopenic impact of steroid therapy can be considered as the cause for alleviation in intestinal lymphoid hyperplasia after steroid treatment.
Being a general intestinal finding on imaging research in kids and children, ILH might of course have been an incidental conclusion, which had resolved spontaneously.
No other potential reason for ILH, like as intestinal infections or hypogamaglobulinemia, could be recognized. Hence, except steroids, no medical treatment could be provided to these children. Surgical approach may be recommended at any stage of treatment.
It is therefore advisable that when recurrent intussusception unearths in fusion with ILH, and no other prominent factor can be detected; trying steroid therapy is worth considering prior to committing the child to either frequent attempts of pneumatic or hydrostatic reduction or opting for radical surgical resection approach.