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A unique case of collagenous colitis presenting as protein-losing enteropathy successfully treated with prednisolone 被引量:3
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作者 Soichi Sano Keiko Yamagami +7 位作者 Ayako Tanaka Minako Nishio Tomoyuki Nakamura Yuki Kubo Takeshi Inoue Wataru Ueda Kiyotaka Okawa Katsunobu Yoshioka 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第39期6083-6086,共4页
A 76-year-old woman with a 5-mo history of recurrent diarrhea and generalized edema was admitted to our hospital. Colonoscopy revealed edematous mucosa,and histopathological examination was compatible with collagenous... A 76-year-old woman with a 5-mo history of recurrent diarrhea and generalized edema was admitted to our hospital. Colonoscopy revealed edematous mucosa,and histopathological examination was compatible with collagenous colitis. Protein leakage from the colon,particularly in the ascending portion,was identified on 99mTc-human serum albumin scintigraphy. Collagenous colitis associated with protein-losing enteropathy (PLE) without small bowel disease was diagnosed. Prednisolone treatment ameliorated diarrhea and hypoproteinemia. Collagenous colitis should be included in the differential diagnosis of chronic diarrhea with hypoproteinemia for appropriate management. 展开更多
关键词 Collagenous colitis protein-losing enteropathy PREDNISOLONE 99mTc-human serum albumin scintigraphy chronic diarrhea
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Protein-losing pseudomembranous colitis with cap polyposis-like features 被引量:2
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作者 Wolfgang Kreisel Guenther Ruf +6 位作者 Richard Salm Adhara Lazaro Bertram Bengsch Anna-Maria Globig Paul Fisch Silke Lassmann Annette Schmitt-Graeff 《World Journal of Gastroenterology》 SCIE CAS 2017年第16期3003-3010,共8页
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 perica... 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. 展开更多
关键词 protein-losing ENTEROPATHY CAP POLYPOSIS ULCERATIVE COLITIS Goblet cells Pseudomembranes
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Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report 被引量:1
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作者 Tomohiko Yasuda Nobuyuki Sakurazawa +7 位作者 Komei Kuge Jun Omori Hiroki Arai Daisuke Kakinuma Masanori Watanabe Hideyuki Suzuki Katsuhiko Iwakiri Hiroshi Yoshida 《World Journal of Clinical Cases》 SCIE 2022年第1期323-330,共8页
BACKGROUND The incidence of internal hernias has recently increased in concordance with the popularization of laparoscopic surgery.Of particular concern are internal hernias occurring in Petersen's space,a space t... BACKGROUND The incidence of internal hernias has recently increased in concordance with the popularization of laparoscopic surgery.Of particular concern are internal hernias occurring in Petersen's space,a space that is surgically created after treatment for gastric cancer and obesity.These hernias cause devastating sequelae,such as massive intestinal necrosis,fatal Roux limb necrosis,and superior mesenteric vein thrombus.In addition,protein-losing enteropathy(PLE)is a rare syndrome involving gastrointestinal protein loss,although its relationship with internal Petersen’s hernias remains unknown.CASE SUMMARY A 75-year-old man with a history of laparotomy for early gastric cancer developed Petersen's hernia 1 year and 5 mo after surgery.He was successfully treated by reducing the incarcerated small intestine and closure of Petersen’s defect without resection of the small intestine.Approximately 3 mo after his surgery for Petersen’s hernia,he developed bilateral leg edema and hypoalbuminemia.He was diagnosed with PLE with an alpha-1 antitrypsin clearance of 733 mL/24 h.Double-balloon enteroscopy revealed extensive jejunal ulceration as the etiology,and it facilitated minimum bowel resection.Pathological analysis showed extensive jejunal ulceration and collagen hyperplasia with nonspecific inflammation of all layers without lymphangiectasia,lymphoma,or vascular abnormalities.His postoperative course was unremarkable,and his bilateral leg edema and hypoalbuminemia improved after 1 mo.There was no relapse over the 5-year follow-up period.CONCLUSION PLE and extensive jejunal ulceration may occur after Petersen's hernia.Doubleballoon enteroscopy helps identify and resect these lesions. 展开更多
关键词 Internal hernia ULCER protein-losing enteropathy Double-balloon enteroscopy Ischemia-reperfusion injury Case report
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Case of protein-losing enteropathy
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作者 Yao MA 《World Journal of Acupuncture-Moxibustion》 CSCD 2019年第3期238-240,共3页
A 77-year-old male patient was diagnosed with protein-losing enteropathy as he had diarrhea for 4 years accompanied with repeated and exacerbated diarrhea and edema of the both lower extremities for more than 1 and a ... A 77-year-old male patient was diagnosed with protein-losing enteropathy as he had diarrhea for 4 years accompanied with repeated and exacerbated diarrhea and edema of the both lower extremities for more than 1 and a half years.In this case,warming-needle moxibustion compiled with the abdominal rubbing that patient performed by himself were utilized.Zhongwan(中脘CV12),Guanyuan(关元CV4);bilateral Tianshu(天枢ST25),Zusanli(足三里ST36),Shangjuxu(上巨虚ST37).Xiajuxu(下巨虚ST39)and the point on three cun below ST39 were taken when warming-needle moxibustion was performed.The treatment was given once a day.After 3 weeks'treatment,the frequency of diarrhea was decreased,the edema disappeared,the seralbumin level was increased,and the symptoms of the patient disappered.Follow-up for half a year,the patients had good prognosis. 展开更多
关键词 protein-losing ENTEROPATHY DIARRHEA ACUPUNCTURE Warming-needle MOXIBUSTION
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Experience of primary intestinal lymphangiectasia in adults: Twelve case series from a tertiary referral hospital 被引量:1
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作者 Ji Eun Na Ji Eun Kim +4 位作者 Sujin Park Eun Ran Kim Sung Noh Hong Young-Ho Kim Dong Kyung Chang 《World Journal of Clinical Cases》 SCIE 2024年第4期746-757,共12页
BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in adults.Nevertheless,the absence of clear guidance from diagnosis to treatment and progn... BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in adults.Nevertheless,the absence of clear guidance from diagnosis to treatment and prognosis poses challenges for both physicians and patients.AIM To enhance understanding by investigating clinical presentation,diagnosis,treatment,complications,and prognoses in adult PIL cases.METHODS We enrolled adult patients diagnosed with PIL between March 2016 and September 2021.The primary outcome involved examining the diagnosis and treatment process of these patients.The secondary outcomes included identifying complications(infections,thromboembolism)and assessing prognoses(frequency of hospitalization and mortality)during the follow-up period.RESULTS Among the 12 included patients,peripheral edema(100%)and diarrhea(75%)were the main presenting complaints.Laboratory tests showed that all the pati-ents exhibited symptoms of hypoalbuminemia and hypogammaglobulinemia.Radiologically,the predominant findings were edema of the small intestine(67%)and ascites(58%).The typical endoscopic finding with a snowflake appearance was observed in 75%of patients.Among the 12 patients,two responded positive-ly to octreotide and sirolimus,and eight who could undergo maintenance therapy discontinued subsequently.Complications due to PIL led to infection in half of the patients,thromboembolism in three patients,and one death.CONCLUSION PIL can be diagnosed in adults across various age groups,with different severity and treatment responses among patients,leading to diverse complications and prognoses.Consequently,tailored treatments will be necessary.We anticipate that our findings will contribute to the management of PIL,an etiology of protein-losing enteropathy. 展开更多
关键词 Primary intestinal lymphangiectasia in adults protein-losing enteropathy Diagnosis Treatment PROGNOSIS
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Eosinophilic gastroenteritis with cytomegalovirus infection in an immunocompetent child 被引量:11
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作者 Junji Takeyama Daiki Abukawa Katsushi Miura 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第34期4653-4654,共2页
A 3-year-old boy developed transient protein-losing gastroenteropathy associated with cytomegalovirus (CMV) infection. Both IgG and IgM antibodies to CMV were positive in a serologic blood test. Upper gastrointestinal... A 3-year-old boy developed transient protein-losing gastroenteropathy associated with cytomegalovirus (CMV) infection. Both IgG and IgM antibodies to CMV were positive in a serologic blood test. Upper gastrointestinal endoscopy showed multiple erosions throughout the body of the stomach, without enlarged gastric folds. Histological examination of the biopsy specimens indicated eosinophilic gastroenteritis and CMV infection. The patient had complete resolution without specific therapy for CMV in four weeks. An allergic reaction as well as CMV infection played important roles in the pathogenesis of this case. 展开更多
关键词 Eosinophilic gastroenteritis CYTOMEGALOVIRUS protein-losing gastroenteropathy ALLERGY Menetrier'sdisease
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Primary intestinal lymphangiectasia with generalized warts 被引量:1
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作者 Soon Jae Lee Hyun Joo Song +3 位作者 Sun-Jin Boo Soo-Young Na Heung Up Kim Chang Lim Hyun 《World Journal of Gastroenterology》 SCIE CAS 2015年第27期8467-8472,共6页
Primary intestinal lymphangiectasia(PIL) is a rare protein-losing enteropathy with lymphatic leakage into the small intestine. Dilated lymphatics in the small intestinal wall and mesentery are observed in this disease... Primary intestinal lymphangiectasia(PIL) is a rare protein-losing enteropathy with lymphatic leakage into the small intestine. Dilated lymphatics in the small intestinal wall and mesentery are observed in this disease. Laboratory tests of PIL patients revealed hypoalbuminemia, lymphocytopenia, hypogammaglobulinemia and increased stool α-1 antitrypsin clearance. Cell-mediated immunodeficiency is also present in PIL patients because of loss of lymphocytes. As a result, the patients are vulnerable to chronic viral infection and lymphoma. However, cases of PIL with chronic viral infection, such as human papilloma virus-induced warts, are rarely reported. We report a rare case of PIL with generalized warts in a 36-year-old male patient. PIL was diagnosed by capsule endoscopy and colonoscopic biopsy with histological tissue confirmation. Generalized warts were observed on the head, chest, abdomen, back, anus, and upper and lower extremities, including the hands and feet of the patient. 展开更多
关键词 protein-losing ENTEROPATHY LYMPHOCYTOPENIA Cell-mediated IMMUNODEFICIENCY PRIMARY intestinallymphangiectasia WARTS
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Lymphangiomatosis associated with protein losing enteropathy:A case report 被引量:1
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作者 Xue-Li Ding Xiao-Yan Yin +3 位作者 Ya-Nan Yu Yun-Qing Chen Wei-Wei Fu Hua Liu 《World Journal of Clinical Cases》 SCIE 2021年第15期3758-3764,共7页
BACKGROUND Lymphangiomatosis is a multisystem disorder that is rarely localized to the gastrointestinal tract.Lymphangiomatosis usually has no specific clinical presentation and is easily misdiagnosed.A case report an... BACKGROUND Lymphangiomatosis is a multisystem disorder that is rarely localized to the gastrointestinal tract.Lymphangiomatosis usually has no specific clinical presentation and is easily misdiagnosed.A case report and review of the literature on lymphangiomatosis associated with protein-losing enteropathy will help to improve the overall understanding of this disease.CASE SUMMARY We report a case of lymphangiomatosis of the bowel and other solid organs.A 78-year-old man presented with recurrent bowel bleeding and protein-losing enteropathy,as well as cystic lesions in the spleen,liver,and kidney.Imaging examinations revealed many cystic lesions on the spleen,liver,kidney,and thickened wall of the ascending colon,as well as pleural effusion and ascites.Colonoscopy revealed a strawberry mucosa,variable spontaneous bleeding,and surface erosion located in the terminal ileum.Several cystic masses with a translucent and smooth surface as well as diffuse white spots were located in the colon.A laterally spreading tumor(LST)was located in the ascending colon.Pathology indicated highly differentiated adenocarcinoma(LST)and lymphangiomatoid dilation,and D2-40 was positive.The final diagnosis was lymphangiomatosis.The patient underwent surgery for LST and then was administered thalidomide 75-150 mg/d.His condition,however,did not improve.He eventually died 6 mo after the initial diagnosis.CONCLUSION Lymphangiomatosis usually occurs diffusely and can involve many organs,such as the spleen,kidney,liver,lung,mesentery,and bowel.Recurrent bowel bleeding or protein-losing enteropathy is an important indicator that should alert clinicians about the possibility of this disease when it afflicts the bowel.Doctors should improve the medical understanding of lymphangiomatosis. 展开更多
关键词 LYMPHANGIOMA Gastrointestinal hemorrhage protein-losing enteropathies Colonic neoplasms Small intestine Case report
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An unusual presentation of fistulating Crohn's disease:Ascites
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作者 Richard Kia David White Sanchoy Sarkar 《World Journal of Gastrointestinal Endoscopy》 CAS 2010年第1期41-43,共3页
Whilst ascites is a common presenting complaint in patients with decompensated chronic liver disease and disseminated malignancy,in Crohn's disease however,it is exceptionally rare.We describe a patient with no pr... Whilst ascites is a common presenting complaint in patients with decompensated chronic liver disease and disseminated malignancy,in Crohn's disease however,it is exceptionally rare.We describe a patient with no prior history of inflammatory bowel or liver disease,presenting with rapid onset gross ascites and scrotal swelling.Further investigations revealed severe hypoalbuminemia and transudative ascitic fluid with normal other liver function tests and a negative liver screen.Computed tomography revealed widespread ascites and pleural effusions with no features of malignancy or portal hypertension,and a small bowel barium series showed features of fistulating small bowel Crohn's disease.An ileo-colonoscopy confirmed the presence of terminal ileal inflammatory stricture.The patient's clinical condition and serum albumin improved with a combination of diuretics,elemental diet,antibiotics and oral 5-aminosalicylic acid therapy. 展开更多
关键词 ASCITES Fistulating Crohn’s DISEASE protein-losing enteropathies HYPOALBUMINEMIA
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Primary intestinal lymphangiectasia presenting as limb convulsions:A case report
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作者 Yun Cao Xiao-Hong Feng Hai-Xiang Ni 《World Journal of Clinical Cases》 SCIE 2022年第18期6234-6240,共7页
BACKGROUND Primary intestinal lymphangiectasia(PIL)is a rare protein-losing enteropathy characterized by abnormally dilated lymphatic structures,resulting in leakage of lymph(rich in protein,lymphocytes,and fat)from t... BACKGROUND Primary intestinal lymphangiectasia(PIL)is a rare protein-losing enteropathy characterized by abnormally dilated lymphatic structures,resulting in leakage of lymph(rich in protein,lymphocytes,and fat)from the intestinal mucosal and submucosal layers and thus hypoproteinemia,lymphopenia,hypolipidemia,and pleural effusion.CASE SUMMARY A 19-year-old Chinese male patient complained of recurrent limb convulsions for the last 1 year.Laboratory investigations revealed low levels of calcium and magnesium along with hypoproteinemia and high parathyroid hormone levels,whereas gastroscopy exhibited chronic non-atrophic gastritis and duodenal lymphatic dilatation.Subsequent gastric biopsy showed moderate chronic inflammatory cell infiltration distributed around a small mucosal patch in the descending duodenum followed by lymphatic dilatation in the mucosal lamina propria,which was later diagnosed as PIL.The following appropriate mediumchain triglycerides nutritional support significantly improved the patient’s symptoms.CONCLUSION Since several diseases mimic the clinical symptoms displayed by PIL,like limb convulsions,low calcium and magnesium,and loss of plasma proteins,it is imperative to conduct a detailed analysis to avoid any misdiagnosis while pinpointing the correct clinical diagnosis and simultaneously ruling out other clinical aspects in the reported cases without any past disease history.A careful assessment should always be made to ensure an accurate diagnosis in a timely manner so that the patient can be delivered quality health services for a positive health outcome. 展开更多
关键词 protein-losing enteropathy Primary intestinal lymphangiectasia Limb convulsions ADULT Case report
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Protein losing enteropathy caused by eosinophilic gastroenteritis:A case report 被引量:1
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作者 Zhu Jiajie Liu Shan +5 位作者 Su Xiaolan Guo Yu Li Yijie Chen Jiande Wang Qingguo Wei Wei 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2018年第6期953-957,共5页
Protein losing enteropathy(PLE), a very rare disease with hypoproteinemia and edema as its characteristics, is caused by various diseases resulting in protein depletion from the gut. The diagnosis is relatively diffic... Protein losing enteropathy(PLE), a very rare disease with hypoproteinemia and edema as its characteristics, is caused by various diseases resulting in protein depletion from the gut. The diagnosis is relatively difficult due to its complex pathogeneses.The present paper reported a case whose symptom started with acute diarrhea and hypoproteinemia.Gastrointestinal endoscopies showed digestive ulcersandcolonpolyp.Thetreatmentscontainedalbumin infusion, Chinese herbal decoction and other symptomatic therapies. The hypoproteinemia become even worse and edema occurred after 4 days' treatment.Alargerdoseofalbumininfusion(40-60g/d) and modified herbal decoctions were prescribed. A final diagnosis of eosinophilic gastroenteritis(EG) complicated with PLE was confirmed by histopathological examination of a repeated gastroscopy. After three weeks' treatment, the serum albumin level was raised and the edema subsided gradually. In conclusion, herbs may have an effect on PLE patients, but PLE resulting from EG is very complex and easy to misdiagnose, especially in atypical conditions. Further studies are required to find the exact mechanisms. 展开更多
关键词 EOSINOPHILS GASTROENTERITIS protein-losing enteropathies Medicine Chinese TRADITIONAL Case REPORTS
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