This may be difficult given the non specific nature of the presenting symptoms and the rarity of the condition itself. It is normally made by the combination of the clinical picture, endoscopic findings and typical histology. Radiology may also be helpful. Other conditions such as infections and vasculitis should be ruled out with the relevant laboratory investigations. Differential diagnosis *Idiopathic ulcerative jejunoileitis *Lymphoma *Infectious agents (Campylobacter, Salmonella, Shigella, Yersinia and others) *Infections in the immunosuppressed with unusual organisms *Tropheryma whipplei, Mycobacterium avium intracellulare *Drug induced (nonsteroidal anti-inflammatory drugs, gold, potassium, chemotherapy) *Zollinger-Ellison syndrome *Heterotopic functioning gastric mucosa *Meckel's diverticulum *Crohn's disease *Traumatic injury (surgical, seat belt injury, endoscopic biopsy, cautery during endoscopy, foreign body ingestion particularly batteries) *Ischemia *Thrombotic diseases *Degos disease *Pseudoxanthoma elasticum *Myeloproliferative disorders *Antithrombin III deficiency *Vasculitis *Coeliac disease *Behçet's disease
Multifocal stenosing ulceration of the small intestine
Eosinophilic ulcer of the oral mucosa
Indolent T cell lymphoproliferative disorder of the gastrointestinal tract
Cystic lesions of the pancreas
Gastric antral vascular ectasia
Duodenal lymphocytosis
Esophageal intramural pseudodiverticulosis
Splenic lymphoma with villous lymphocytes