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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 celiac sprue.

Anemia, diarrhea, electrolyte derangement, hyposplenism, duodenal ulceration, total parenteral nutrition are the most frequent features.

Check volemia, baseline cell blood count, and electrolytes.

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 implications.

Cardenas A, Kelly CP: Celiac sprue. Semin Gastrointest Dis 13:232, 2002.  [PubMed: 12462708]
Freeman HJ: Small bowel malignant lymphoma complicating celiac sprue and the mesenteric lymph node cavitation syndrome. Gastroenterology 90:2008, 1986.  [PubMed: 3699417]

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