ABSTRACT
Pseudomembranous colitis can be induced by the therapeutic or prophylactic use of antibiotics, and antibiotics- induced colitis has become a severe clinical problem. Protein?loosing enteropathy is associated with an abnormal, excessive loss of serum proteins into the gastrointestinal tract, and this leads to hypoproteinemia, including hypoalbuminemia, edema and diarrhea. We present here a case of protein?loosing enteropathy that was induced by pseudomembranous colitis, and this was induced by the use of antibiotics. Patients with chronic renal disease and peritonitis show hypoalbuminemia and edema. We experienced a patient who displayed edema, hypoalbuminemia, diarrhea and a fever for several days after the use for antibiotics for treating his peritonitis. We made the diagnosis of protein-loosing enteropathy complicated by psuedomembranous colitis. In a patient with peritonitis, uncontrolled edema and diarrhea, and the patient's hypoalbuminemia is continued, we must consider the possibility that the patient has protein-loosing enteropathy, and we should examine the total protein level and the alpha 1-antitrypsin clearance.
Subject(s)
Humans , alpha 1-Antitrypsin , Anti-Bacterial Agents , Blood Proteins , Colitis , Diarrhea , Edema , Enterocolitis, Pseudomembranous , Fever , Gastrointestinal Tract , Hypoalbuminemia , Hypoproteinemia , Peritonitis , Renal Insufficiency, ChronicABSTRACT
Primary intestinal lymphangiectasia is a rare congenital cause of protein losing enteropathy that is characterized by chronic diarrhea, generalized edema, ascites, hypoproteinemia, hypoalbuminemia, and lymphopenia. We encountered an 18-year-old woman who suffered from longstanding diarrhea and progressive leg edema. The laboratory findings showed the typical features of this disorder. The presence of enteric protein loss was documented with the 24 hour fecal clearance of alpha(1)-antitrypsin and (99m)Tc human serum albumin scintigraphy. A duodenoscopy and biopsy showed scattered white spots and markedly dilated lymphatics in the tips of the villi, respectively. The patient's clinical symptoms improved after placing her on a high protein and low fat diet with medium chain triglyceride supplements.
Subject(s)
Adolescent , Female , Humans , Ascites , Biopsy , Dental Caries , Diarrhea , Diet , Duodenoscopy , Edema , Hypoalbuminemia , Hypoproteinemia , Leg , Lymphopenia , Protein-Losing Enteropathies , Radionuclide Imaging , Serum Albumin , TriglyceridesABSTRACT
Protein-losing enteropathy (PLE) is a rare manifestation of systemic lupus erythematosus (SLE), and it is an uncommon cause of hypoalbuminemia without proteinuria. We describe a case of an 11 year-old girl who had diarrhea and periorbital edema as the initial symptoms of SLE. PLE was diagnosed by 24-hour stool alpha-1 antitrypsin clearance and 99mTc-human serum albumin scintigraphy.
Subject(s)
Child , Female , Humans , Lupus Erythematosus, Systemic/complications , Protein-Losing Enteropathies/etiologyABSTRACT
Protein losing enteropathy (PLE) is characterized by the loss of protein into the gastrointestinal tract that results in hypoalbuminemia and generalized edema. PLE is associated with several clinical disorders, but it is a rare manifestation of systemic lupus erythematosus (SLE), and it may be the presenting manifestation of SLE. We report a patient with SLE presenting with PLE, in whom methylprednisolone pulse therapy was highly effective. A 29-year-old women was admitted to our hospital with generalized edema. Laboratory findings revealed hypoalbuminemia, hypercholesterolemia and antinuclear antibody 1:160, speckled type. Mucosal biopsies of the duodenal bulb and terminal ileum revealed edema and dilated lymphatics with infiltration of chronic inflammatory cells. PLE was diagnosed by marked elevation of alpha-1 antitrypsin clearance in stool and abnormal radioactivity within small intestine on 99mTc-labeled human serum albumin scan. Hypoalbuminemia and generalized edema improved rapidly after methylprednisolone pulse therapy.