Idiopathic enlargement of mesenteric lymph nodes
associated with debilitating sprue.
Extremely rare; only occurs in association with celiac
sprue (or disease).
Uncertain. Debilitated patients with celiac sprue
develop mesenteric lymph node enlargement and cavitation, anemia, and
duodenal ulcerations. This leads to worsening of the failure to thrive most often
associated with celiac sprue.
Based on the clinical picture. Patients may have
repeated negative biopsies for lymphoma, despite a highly suspicious
presentation. Lymphoreticular syndrome is diagnosed in the presence of
Anemia, diarrhea, electrolyte derangement,
hyposplenism, duodenal ulceration, total parenteral nutrition are the most frequent features.
Check volemia, baseline cell blood count, and
The anesthetic considerations must be adapted
according to the procedure. For instance, discontinue total parenteral nutrition
perioperatively and adapt intravenous glucose administration (10% solution might be
necessary) to prevent hypoglycemia.
No reported pharmacological
Cardenas A, Kelly CP: Celiac sprue. Semin Gastrointest Dis
Freeman HJ: Small bowel malignant lymphoma complicating celiac sprue and the
mesenteric lymph node cavitation syndrome. Gastroenterology