Protein-losing enteropathy as a result of colon polyposis and colon cancer: a multidisciplinary approach to diagnosis and treatment.
Hendrien KuipersHenderik L van WestreenenFreek C P MollWouter H de Vos Tot Nederveen CappelPublished in: BMJ case reports (2024)
A man in his 60s presented to our emergency department with severe peripheral pitting oedema, weight gain, dyspnoea and diarrhoea. Blood tests showed a hypoalbuminaemia of 15 g/L. A suspicion of protein-losing enteropathy arose after the exclusion of albuminuria, cardiac failure, protein deficiency and liver cirrhosis. An abdominal CT scan revealed a wall thickening of the colon, and a subsequent colonoscopy identified multiple large obstructive polyps in the ascending colon. The patient underwent a right hemicolectomy which revealed the presence of tubulovillous polyps and a pT2N0 colon carcinoma. Following surgery, the patient experienced clinical improvement with normalisation of serum albumin and resolution of the oedema.Protein-losing enteropathy should be considered an underlying syndrome in patients with peripheral oedema and hypoalbuminaemia in the absence of cardiac failure, proteinuria, malnutrition and hepatic disease. This diagnostic process requires a multidisciplinary approach. For adequate treatment, the primary cause of protein-losing enteropathy needs to be investigated.
Keyphrases
- weight gain
- emergency department
- protein protein
- amino acid
- case report
- computed tomography
- high resolution
- small molecule
- magnetic resonance
- magnetic resonance imaging
- acute coronary syndrome
- atrial fibrillation
- pulmonary hypertension
- coronary artery bypass
- single molecule
- pet ct
- atomic force microscopy
- colorectal cancer screening