Protein losing enteropathy
| Protein losing enteropathy | |
| ICD-9 | 579.8 |
|---|---|
| OMIM | 226300 |
| DiseasesDB | 10811 |
| MedlinePlus | 002277 |
| MeSH | D011504 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Synonyms and keywords: protein loss, protein deficiency, GI protein loss, gastrointestinal protein loss, protein-losing gastroenteropathy, protein losing gastroenteropathy, gastroenteropathy, gastric protein loss, Helicobacter pylori, H pylori, giant hypertrophic gastropathy, Menetrier disease, Ménétrier, disease, loss of plasma proteins from the gastrointestinal tract, excessive leakage of plasma proteins into the lumen of the gastrointestinal tract, lymphatic obstruction, mucosal disease with erosions, ulcerations, swelling of the legs, peripheral edema, decreased plasma oncotic pressure
Overview
Protein losing enteropathy is the loss of plasma proteins from the gastrointestinal tract caused by an array of abnormalities
Historical Perspective
[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].
The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].
Presentation
- The condition may manifest itself with complications related to protein loss, including edema, or retention of fluid, and ascites, or retention of fluid in the abdomen. Proteins are absorbed in the small bowel, and any condition that affects the digestion or absorption of protein can result in protein losing enteropathy.
Common Causes
Most cases of protein losing enteropathy are caused as a result of:
- Primary gastrointestinal disorders
- Lymphatic obstruction
Primary Gastrointestinal Diseases
Mucosal Erosions/Ulcerations
Primary gastrointestinal diseases causing erosion or ulceration of the mucosa of the gut leading to fecal loss of proteins such as:
- Inflammatory bowel diseases (Crohn disease, Ulcerative colitis)
- Malignancies involving the gut mucosa
- Graft vs. host disease
- Esophageal and gastric erosions or ulcerations
- Carcinoid syndrome
- Bacterial infection with Clostridium difficile causing pseudomembranous colitis
- Parasitic infection with Giardia
Non-Erosive/Ulcerative Mucosal involvement
- Celiac Disease
- Eosinophilic Gastritis
- Hypertrophic Gastritis
- Connective Tissue Disorders: Systemic Lupus Erythmatosis
- Cutaneous burns
Lymphatic Obstruction
Conditions responsible for causing lymphatic obstruction leading to the leakage of lymph into the lumen of gut such as:
- Lymphoma
- Congenital or acquired lymphatic diseases
- Lymphatic Filariasis
- Sarcoidosis
- Cardiovascular diseases: Congestive heart failure, Restrictive pericarditis
- Intestinal Tuberculosis
- Fortan surgical procedure
- Cirrhosis with portal hypertension
- Retroperitoneal fibrosis
Complete Differential Diagnosis Of Underlying Causes
- Acute gastroenteritis
- AIDS
- Allergic Gastroenteritis
- Amyloidosis
- Angioedema
- Bacterial overgrowth
- Carcinoid Syndrome
- Celiac Sprue
- Clostridium Difficile
- Congestive Heart Failure
- Connective tissue disorders
- Constrictive pericarditis
- Crohn's Disease
- Duodenal erosions or ulcerations
- Esophageal erosions or ulcerations
- Graft vs. Host Disease
- Henoch-Schonlein Purpura
- Idiopathic ulcerative jejunoileitis
- Intestinal endometriosis
- Intestinal parasites
- Kaposi Sarcoma
- Lymphoenteric fistula
- Lymphoma
- Menetrier's Disease
- Microscopic colitis
- Mucosal-based neoplasm
- Neurofibromatosis
- Protein dyscrasia
- Pseudomembranous colitis
- Retroperitoneal fibrosis
- Sarcoidosis
- Stomach (erosions, ulcerations)
- Tropical sprue
- Tuberculosis
- Ulcerative Colitis
- Whipple's Disease
Diagnosis
The diagnosis of protein losing enteropathy is typically made by excluding other causes of protein loss, such as nephrotic syndrome. Endoscopy and barium imaging can be used to localize the cause of the protein loss in the bowel.
Treatment
Treatment depends upon the underlying condition.