Protein Losing Enteropathy
Clinical Presentation:
• Volume overload: Peripheral edema, pleural effusion or ascites.
• Gl symptoms if underlying disease.
• Increased susceptibility infections.
• Malnutrition (fat soluble vitamins)
Diagnosis:
• Suspect in patients without apparent cause of protein loss (e.g. proteinuria) or inadequate synthesis or supply.
• Increase in alpha-1 antitrypsin clearance
• Determine underlying etiology
Etiologies:
• Erosive Gl diseases: UC/Crohn, Gl malignancies
• Non-erosive Gl diseases: Intestinal diseases (e.g. Celiac), Amyloidosis
• Disorders with lymphatics: Primary or secondary
Treatment:
• Dietary therapy: Low-fat, High-protein, medium-chain triglycerides.
- MCT Bypass the lymphatic circulation.
- Very High protein (1.5 - 3 g/kg)
• Treatment of the underlying disease
• Octreotide (??)
- UTSWIM Chiefs @UTSWIMchief
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