Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1990 Jan;43(1):57–59. doi: 10.1136/jcp.43.1.57

Small intestinal bacterial overgrowth in patients with chronic lymphocytic leukaemia.

G M Smith 1, I M Chesner 1, P Asquith 1, M J Leyland 1
PMCID: PMC502225  PMID: 2312752

Abstract

As part of a study to assess the possible contribution of lymphoid infiltration of the gastrointestinal mucosa to occult blood loss or malabsorption 20 patients with chronic lymphocytic leukaemia (CLL) had a lactulose hydrogen breath test. In 10 cases (50%) a small intestinal peak was detected, suggesting small bowel bacterial overgrowth, and this was confirmed in seven patients by the positive culture of jejunal aspirate. Of the patients with a positive hydrogen breath test, radiological examination showed a duodenal diverticulum in two but no anatomical abnormalities in the other cases. There was no evidence of achlorhydria and transit times were normal. There was no difference in the incidence of hypogammaglobulinaemia among those patients with evidence of small intestinal bacterial overgrowth and those without. Seven patients with a positive hydrogen breath test, however, had undetectable secretory piece in their jejunal aspirates whereas this was present in all patients with a normal breath test who had local immunoglobulin concentrations measured (p less than 0.05), indicating that the small intestinal bacterial overgrowth may be due to impaired local immunity.

Full text

PDF
57

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bond J. H., Jr, Levitt M. D. Use of pulmonary hydrogen (H 2 ) measurements to quantitate carbohydrate absorption. Study of partially gastrectomized patients. J Clin Invest. 1972 May;51(5):1219–1225. doi: 10.1172/JCI106916. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brown W. R. Nonimmunoglobulin precipitin lines between intestinal fluids and antisera in immunodiffusion studies: an explanation for their occurrence and how they can be avoided. J Lab Clin Med. 1971 Feb;77(2):326–334. [PubMed] [Google Scholar]
  3. Chronic lymphocytic leukaemia: proposals for a revised prognostic staging system. Report from the International Workshop on CLL. Br J Haematol. 1981 Jul;48(3):365–367. doi: 10.1111/j.1365-2141.1981.tb02727.x. [DOI] [PubMed] [Google Scholar]
  4. Fox W. Compliance of patients and physicians: experience and lessons from tuberculosis-II. Br Med J (Clin Res Ed) 1983 Jul 9;287(6385):101–105. doi: 10.1136/bmj.287.6385.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Metz G., Gassull M. A., Drasar B. S., Jenkins D. J., Blendis L. M. Breath-hydrogen test for small-intestinal bacterial colonisation. Lancet. 1976 Mar 27;1(7961):668–669. doi: 10.1016/s0140-6736(76)92779-3. [DOI] [PubMed] [Google Scholar]
  6. PITNEY W. R., JOSKE R. A., MACKINNON N. L. Folic acid and other absorption tests in lymphosarcoma, chronic lymphocytic leukaemia, and some related conditions. J Clin Pathol. 1960 Sep;13:440–447. doi: 10.1136/jcp.13.5.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Parkin D. M., McClelland D. B., O'Moore R. R., Percy-Robb I. W., Grant I. W., Shearman D. J. Intestinal bacterial flora and bile salt studies in hypogammaglobulinaemia. Gut. 1972 Mar;13(3):182–188. doi: 10.1136/gut.13.3.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Rhodes J. M., Middleton P., Jewell D. P. The lactulose hydrogen breath test as a diagnostic test for small-bowel bacterial overgrowth. Scand J Gastroenterol. 1979;14(3):333–336. doi: 10.3109/00365527909179892. [DOI] [PubMed] [Google Scholar]
  9. Shearman D. J., Parkin D. M., McClelland D. B. The demonstration and function of antibodies in the gastrointestinal tract. Gut. 1972 Jun;13(6):483–499. doi: 10.1136/gut.13.6.483. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Smith G., Crocker J., Nar P., Chesner I., Leyland M. J. Immunogold-silver technique applied to showing malignant B cell infiltration of gastrointestinal tract in patients with chronic lymphocytic leukaemia and non-Hodgkin's lymphoma. J Clin Pathol. 1987 Jul;40(7):756–759. doi: 10.1136/jcp.40.7.756. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Theml H., Ziegler-Heitbrock H. W. Management of CLL and allied disorders with reference to their immunology and proliferation kinetics. Recent Results Cancer Res. 1984;93:240–258. doi: 10.1007/978-3-642-82249-0_10. [DOI] [PubMed] [Google Scholar]
  12. Thompson R. A. Secretory piece linked to IgM in individuals deficient in IgA. Nature. 1970 Jun 6;226(5249):946–948. doi: 10.1038/226946a0. [DOI] [PubMed] [Google Scholar]
  13. Webster A. D. The gut and immunodeficiency disorders. Clin Gastroenterol. 1976 May;5(2):323–340. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES