J Korean Med Sci.  2004 Jun;19(3):466-469. 10.3346/jkms.2004.19.3.466.

Successful Treatment of Protein-Losing Enteropathy Induced by Intestinal Lymphangiectasia in a Liver Cirrhosis Patient with Octreotide: A Case Report

• Lee HL
• Han DS
• Kim JB
• Jeon YC
• Sohn JH
• Hahm JS

• KMID: 1786830
• DOI: http://doi.org/10.3346/jkms.2004.19.3.466

Abstract

A 47-yr-old man with hepatitis B virus associated liver cirrhosis was admitted to our hospital with diarrhea and generalized edema and diagnosed as protein-losing enteropathy due to intestinal lymphangiectasia by intestinal biopsy and 99mTc albumin scan. During hospitalization, he received subcutaneous octreotide therapy. After 2 weeks of octreotide therapy, follow-up albumin scan showed no albumin leakage, and the serum albumin level was sustained. We speculate that liver cirrhosis can be a cause of intestinal lymphangiectasia and administration of octreotide should be considered for patients with intestinal lymphangiectasia whose clinical and biochemical abnormalities do not respond to a low-fat diet.

Keyword

Lymphagiectasis, Intestinal; Protein-Losing Enteropathies; Octreotide

MeSH Terms

Adolescent
Adult
Duodenum/pathology
Female
Hepatitis B/complications
Hepatitis B Virus/metabolism
Human
Intestinal Diseases/*drug therapy/virology
Jejunum/pathology
Liver Cirrhosis/*drug therapy/virology
Lymphangiectasis, Intestinal/*drug therapy/virology
Male
Middle Aged
Octreotide/*pharmacology
Protein-Losing Enteropathies/*drug therapy

Figure

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  Fig. 1 Albumin scan shows protein-losing at the jejunum level after 2 hr of injection and subsequently moved distal jejunum, ileum, and colon.

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  Fig. 2 Duodenoscopy shows serosanguinous exudates in the duodenal mucosa, mucosal erosion, and erythema in the duodenal 3rd portion.

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  Fig. 3 Histological examination of a biopsy from the duodenum. (A) None the markedly dilated lymphatics in the lamina propria (H&E stain, ×100). (B) The dilated lymphatics are more clearly shown (H&E stain, ×200).

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