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Tuesday, March 8, 2011

PROTEIN-LOSING ENTEROPATHY

This term is used when there is excessive loss of protein in to the lumen of the gastrointestinal tract, the loss being sufficient to cause hypoproteinaemia. Protein-losing enteropathy occurs in many gastrointestinal disorders but is most common in those which ulceration of the intestine.
Disease producing protein-losing enteropathy

  • Disease of the stomach e.g. Menetrier's disease
  • Disease of intestinal lymphatics - Intestinal lymphangiectasia, primary or secondary
  • Inflammatory disease of gut- Inflammatory bowel disease, parasitic infections, Bind loop syndrome
  • Tumors- Gastric, small intestine, colonic, familial polyposis
  • Coeliac disease
  • Tropical sprue
  • Radiation enteritis
  • Collagen-vascular disease
  • Whipple's disease
  • Allergic gastroenteropathy
  • Constrictive pericarditis
Clinical features
The patient has peripheral oedema and hypo proteinaemia in the presence of normal liver function, in that there is no evidence of failure of hepatic synthesis of plasma proteins, no evidence of proteinuria, and no cardiac failure.

Investigation
The diagnosis is confirmed by measurement of the faecal clearence of endogenous alpha 1-antitrypsin.

Management
Treatment is that of the underlying condition.

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