ABSTRACT
Protein-losing enteropathy (PLE) is characterized by loss of serum proteins into the gastrointestinal tract. It may lead to hypoproteinemia and clinically present as protein deficiency edema, ascites, pleural or pericardial effusion and/or malnutrition. In most cases the site of protein loss is the small intestine. Here we present an unusual case of severe PLE in a 55-year old female with a one-year history of recurrent diarrhea, crampy abdominal pain, and peripheral edema. Endoscopy and MRI showed a diffuse inflammatory thickening of the sigmoid colon and the rectum. Surgical resection of the involved colon was performed and the symptoms were significantly resolved. The final histologic evaluation confirmed a diagnosis of a pseudomembranous colitis with cap polyposis-like features. Such a cause of PLE has never been described before.
Subject(s)
Colon , Colonic Polyps/complications , Enterocolitis, Pseudomembranous/complications , Protein-Losing Enteropathies/etiology , Biopsy , Colectomy , Colon/immunology , Colon/pathology , Colon/surgery , Colonic Polyps/diagnosis , Colonic Polyps/surgery , Colonoscopy , Enterocolitis, Pseudomembranous/diagnosis , Enterocolitis, Pseudomembranous/surgery , Female , Humans , Immunohistochemistry , Magnetic Resonance Imaging , Middle Aged , Protein-Losing Enteropathies/diagnosis , Severity of Illness Index , Treatment OutcomeABSTRACT
CASE REPORT: The authors report on a 51-year-old patient with transient pareses, myalgias, and a massive creatine kinase elevation which had led to an intensive neurological work-up by the general practitioner. Despite refractory hypertension, primary aldosteronism was not excluded. At the authors' clinic, the patient was diagnosed to have Conn's syndrome. Laparoscopic adrenalectomy revealed a big adenoma of the left adrenal gland. CONCLUSION: Transient pareses, myalgias, and creatine kinase elevation can indicate primary aldosteronism among hypertensive patients. If clinically suspected, the aldosterone-renin ratio should be determined.