Korean J Gastroenterol.  2007 Jan;49(1):31-36.

A Case of Protein-losing Enteropathy Associated with Small Bowel Villous Atrophy

• Han SH
• Lee OY
• Eun CS
• Roh BJ
• Sohn W
• Baeg SS
• Yoon BC
• Choi HS

Abstract

Protein losing enteropathy is described as a diverse group of disorders associated with excessive loss of serum proteins into the gastrointestinal (GI) tract. The etiology of protein losing enteropathy is various. Increased mucosal permeability to protein as a result of cell damage, mucosal erosion, or lymphatic obstruction may develop protein losing enteropathy. Celiac disease is a common cause of protein losing enteropathy associated with small bowel villous atrophy in Europe. We experienced a case of protein losing enteropathy associated with small bowel villous atrophy of unknown origin. A 36-year-old woman was admitted due to chronic watery diarrhea and weight loss. Laboratory findings showed total protein 4.7 g/dL, albumin 2.7 g/dL, cholesterol 100 mg/dL, WBC 6,000/mm(3) (lymphocyte 13.6%) with the absence of proteinuria. On esophagogastroduodenoscopic examination, duodenal ulcer scar was noted on the bulb and colonoscopic finding was nonspecific. On small bowel enteroscopy, jejunal and ileal villi was scantly noticed. Small bowel biopsy showed marked villous atrophy. Her symptoms did not improve after supportive care. Gluten free diet was tried because celiac disease could not be ruled out completely. Diarrhea ceased and body weight regained after gluten free diet.

Keyword

Protein losing enteropathy; Small bowel villous atrophy; Celiac disease

MeSH Terms

Adult
Atrophy
Celiac Disease/*pathology
Colonoscopy
Female
Humans
Ileum/*pathology
Immunohistochemistry
Intestinal Mucosa/pathology
Jejunum/*pathology
Protein-Losing Enteropathies/*etiology
Serum Albumin/diagnostic use
Technetium Tc 99m Aggregated Albumin/diagnostic use
Tomography, X-Ray Computed