Reviewer's report
Title:Diffuse duodenal nodular lymphoid hyperplasia: A large cohort of patients
etiologically related to helicobacter pylori infection.
Version: 1Date:16 December 2010
Reviewer: vatsala misra
Reviewer's report:
Diffuse duodenal nodular lymphoid hyperplasia
Reviewer’s comments:
Back ground and Introduction –
The authors state – “There are no published reports of association of nodular
lymphoid hyperplasia in association with H.pylori infection”
Probably they have not searched the literature properly. Few reports from India
are quoted below and there are more from other parts of the world –
Misra SP, Misra V, Dwivedi M, Singh PA. Helicobacter pylori induced
lymphonodular hyperplasia: a new cause of gastric outlet obstruction Journal Of
Gastroenterology And Hepatology 1998; 13: 1189-92.
Dwivedi M, Misra SP, Misra V. Nodular gastritis in adults: Clinical features,
endoscpic appearance, histological feature and response to therapy. J
Gastroenterol and Hepatol 2008;23:943-7.
Material and methods –
Which classification was used to classify gastritis and duodenitis on histology?
Please give method of doing RUT
Results: -
It appears to be quite unusual that despite 100% biopsies showing presence of
H. pylori (heavy in 34 patients), only 2 patients had MALToma and rest others
had no evidence of lymphoid hyperplasia in stomach but all the cases had
nodules in the duodenum.
How many duodenal biopsies had evidence of gastric metaplasia and evidence
of H.pylori
How the H.pylori present in the stomach led to nodular lymphoid hyperplasia in
the duodenum without producing any change in the gastric mucosa – please
explain
Diagnosis of H.pylori was made by RUT and histology but after treatment only
Breath test was used
How can you compare the three different methods for showing eradication.
A pre and post Urea breath test should have been done to show the eradication.
Discussion –
Authors try to state that the nodules in the duodenum were probably due to
immune stimulation secondry to heavy H.pylori infection.If it was so, then how the
stomach, small intestine and colon were spared
References – Most of the references are quite old.some new references should
be added.
Photographs –
Histology photograph is not good. Getting a single lymphoid follicle is not
unusual. A scanner or low magnification (10x) showing multiple large follicles
should be given
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I've no competing interests
Reviewer's report
Title:Diffuse duodenal nodular lymphoid hyperplasia: A large cohort of patients
etiologically related to helicobacter pylori infection.
Version: 1Date:16 December 2010
Reviewer: vatsala misra
Reviewer's report:
Diffuse duodenal nodular lymphoid hyperplasia
Reviewer’s comments:
Back ground and Introduction –
The authors state – “There are no published reports of association of nodular
lymphoid hyperplasia in association with H.pylori infection”
Probably they have not searched the literature properly. Few reports from India
are quoted below and there are more from other parts of the world –
Misra SP, Misra V, Dwivedi M, Singh PA. Helicobacter pylori induced
lymphonodular hyperplasia: a new cause of gastric outlet obstruction Journal Of
Gastroenterology And Hepatology 1998; 13: 1189-92.
Dwivedi M, Misra SP, Misra V. Nodular gastritis in adults: Clinical features,
endoscpic appearance, histological feature and response to therapy. J
Gastroenterol and Hepatol 2008;23:943-7.
Material and methods –
Which classification was used to classify gastritis and duodenitis on histology?
Please give method of doing RUT
Results: -
It appears to be quite unusual that despite 100% biopsies showing presence of
H. pylori (heavy in 34 patients), only 2 patients had MALToma and rest others
had no evidence of lymphoid hyperplasia in stomach but all the cases had
nodules in the duodenum.
How many duodenal biopsies had evidence of gastric metaplasia and evidence
of H.pylori
How the H.pylori present in the stomach led to nodular lymphoid hyperplasia in
the duodenum without producing any change in the gastric mucosa – please
explain
Diagnosis of H.pylori was made by RUT and histology but after treatment only
Breath test was used
How can you compare the three different methods for showing eradication.
A pre and post Urea breath test should have been done to show the eradication.
Discussion –
Authors try to state that the nodules in the duodenum were probably due to
immune stimulation secondry to heavy H.pylori infection.If it was so, then how the
stomach, small intestine and colon were spared
References – Most of the references are quite old.some new references should
be added.
Photographs –
Histology photograph is not good. Getting a single lymphoid follicle is not
unusual. A scanner or low magnification (10x) showing multiple large follicles
should be given
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I've no competing interests
Please review this paper.
user
Reviewer's report
Title:Diffuse duodenal nodular lymphoid hyperplasia: A large cohort of patients
etiologically related to helicobacter pylori infection.
Version: 1Date:16 December 2010
Reviewer: vatsala misra
Reviewer's report:
Diffuse duodenal nodular lymphoid hyperplasia
Reviewer’s comments:
Back ground and Introduction –
The authors state – “There are no published reports of association of nodular
lymphoid hyperplasia in association with H.pylori infection”
Probably they have not searched the literature properly. Few reports from India
are quoted below and there are more from other parts of the world –
Misra SP, Misra V, Dwivedi M, Singh PA. Helicobacter pylori induced
lymphonodular hyperplasia: a new cause of gastric outlet obstruction Journal Of
Gastroenterology And Hepatology 1998; 13: 1189-92.
Dwivedi M, Misra SP, Misra V. Nodular gastritis in adults: Clinical features,
endoscpic appearance, histological feature and response to therapy. J
Gastroenterol and Hepatol 2008;23:943-7.
Material and methods –
Which classification was used to classify gastritis and duodenitis on histology?
Please give method of doing RUT
Results: -
It appears to be quite unusual that despite 100% biopsies showing presence of
H. pylori (heavy in 34 patients), only 2 patients had MALToma and rest others
had no evidence of lymphoid hyperplasia in stomach but all the cases had
nodules in the duodenum.
How many duodenal biopsies had evidence of gastric metaplasia and evidence
of H.pylori
How the H.pylori present in the stomach led to nodular lymphoid hyperplasia in
the duodenum without producing any change in the gastric mucosa – please
explain
Diagnosis of H.pylori was made by RUT and histology but after treatment only
Breath test was used
How can you compare the three different methods for showing eradication.
A pre and post Urea breath test should have been done to show the eradication.
Discussion –
Authors try to state that the nodules in the duodenum were probably due to
immune stimulation secondry to heavy H.pylori infection.If it was so, then how the
stomach, small intestine and colon were spared
References – Most of the references are quite old.some new references should
be added.
Photographs –
Histology photograph is not good. Getting a single lymphoid follicle is not
unusual. A scanner or low magnification (10x) showing multiple large follicles
should be given
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I've no competing interests
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