Kosin Med J.  2017 Jun;32(1):84-89. 10.7180/kmj.2017.32.1.84.

A Case of Protein Losing Enteropathy as Only Clinical manifestation of Systemic Lupus Erythematosus

• Kim TH
• Choi YH
• Kang LH
• Kim HJ
• Jang JH
• So MW

• KMID: 2384836
• DOI: http://doi.org/10.7180/kmj.2017.32.1.84

Abstract

Protein losing enteropathy (PLE) due to systemic lupus erythematosus (SLE) is relatively uncommon. PLE may be appeared sequentially after the diagnosis of SLE or concurrently with SLE. In most of concurrent cases, PLE was diagnosed one of various symptoms of SLE. Cases of PLE as the initial and only clinical presentation of SLE have been rarely reported. We described a 30-year old woman with general edema and abdominal distension was diagnosed PLE after stool alpha 1 antitrypsin clearance test. Her symptoms were getting worse even though the treatment with intravenous albumin. She was finally diagnosed PLE associated with SLE by additional laboratory findings (positive antinuclear antibody and anti-dsDNA IgG and low C3, C4 and CH50). She was treated with high dose of steroids and her symptoms were improved.

Keyword

Protein losing enteropathy; Systemic lupus erythematosus

MeSH Terms

alpha 1-Antitrypsin
Antibodies, Antinuclear
Diagnosis
Edema
Female
Humans
Immunoglobulin G
Lupus Erythematosus, Systemic*
Protein-Losing Enteropathies*
Steroids
Antibodies, Antinuclear
Immunoglobulin G
Steroids
alpha 1-Antitrypsin

Figure

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  Fig. 1 Computed tomography scan of abdomen showed (A) diffuse bowel thickening (B) large amount of ascites.

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  Fig. 2 (A) Gastrofibroscopy showed duodenum edema (B) Colon fibroscopy showed colon edema.

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  Fig. 3 Graphic representation of the serum levels of albumin (alb) and C3 with methyprednisolone (methyPRS) and azathioprine (AZA) treatment. Levels of serum Albumin and C3 gradually returned to within normal limits.

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