Immunoproliferative Small Intestinal Disease — A Third-World Lesion

THE term "immunoproliferative small intestinal disease" (IPSID) covers a variety of disorders commonly manifested by diarrhea, weight loss, abdominal pain, and clubbing of fingers and toes.^{1 2 3 4 5 6} The presenting features of the disease are attributed primarily to the presence of diffuse and intense lymphoplasmacytic infiltration of the proximal small intestinal mucosa and mesenteric lymph nodes.^{1 2 3 4 5 6 7 8 9 10 11 12} The infiltrating cells are variably responsible for synthesizing aberrant alpha-heavy-chain immunoglobulin and forming a matrix for the evolution of primary enteromesenteric lymphoma.^{2 , 11 12 13} Although IPSID is a rarity of only academic interest in developed countries,^{14 15 16} it is a prevalent, debilitating illness that afflicts the less prosperous segments . . .