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Correspondence
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Volume 349:1482 October 9, 2003 Number 15
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Case 11-2003: Ulcerative Colitis and Primary Sclerosing Cholangitis in a 14-Year-Old Boy

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by Ross, A. M.
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To the Editor: Case 11-2003 (April 10 issue)1 describes a 14-year-old boy with recurrent cholangitis complicating ulcerative colitis. The authors state that this presentation is unusual in such a young patient. We report a similar experience of a malignant duodenal tumor complicating the treatment of an 11-year-old boy with X-linked hyper-IgM combined immunodeficiency.2

The histologic diagnosis was duodenal neuroendocrine carcinoma, which makes this boy the youngest reported patient with this condition. The association of neuroendocrine tumors with the X-linked hyper-IgM syndrome is recognized and has been linked with hepatobiliary cryptosporidiosis and cholangitis, justifying early liver transplantation.3 In the case of . . . [Full Text of this Article]



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