Hsieh Tsu-Yi, Lan Joung-Liang, Chen Der-Yen
Section of Allergy, Immunology and Rheumatology, Department of Medicine, National Yang-Ming University, Taichung Veterans General Hospital, Taichung, Taiwan.
J Formos Med Assoc. 2002 Jul;101(7):519-22.
Protein-losing gastroenteropathy is a rare complication in autoimmune diseases, especially in Sjögren's syndrome. We report two cases of primary Sjögren's syndrome, one in a 37-year-old female and another in a 50-year-old female, both of whom presented with peripheral edema. Protein-losing gastroenteropathies of the stomach and small intestine in the first patient and of the small intestine only in the second patient were demonstrated by abdominal Tc-99m labeled albumin abdominal scintigraphy and pathologic findings. Results of gastrointestinal tract biopsies from both patients showed chronic inflammatory cell infiltrations without lymphangiectasis or vasculitis. The patients were successfully treated with corticosteroids. Results of follow-up Tc-99m labeled albumin scintigraphy were well correlated with clinical improvement and the increase in serum albumin. Sjögren's syndrome should be considered as a cause of protein-losing enteropathy. Tc-99m labeled albumin abdominal scintigraphy is helpful in diagnosing the condition, locating the protein-losing sites, and monitoring the treatment outcome, especially in cases where protein loss occurs in the stomach.
蛋白丢失性胃肠病是自身免疫性疾病中的一种罕见并发症，尤其是在干燥综合征中。我们报告两例原发性干燥综合征病例，一例为37岁女性，另一例为50岁女性，二者均表现为外周水肿。通过腹部99m锝标记白蛋白腹部闪烁扫描及病理检查结果证实，第一例患者存在胃和小肠的蛋白丢失性胃肠病，第二例患者仅存在小肠的蛋白丢失性胃肠病。两名患者的胃肠道活检结果均显示慢性炎性细胞浸润，无淋巴管扩张或血管炎。患者接受皮质类固醇治疗后取得成功。随访的99m锝标记白蛋白闪烁扫描结果与临床改善情况及血清白蛋白升高情况密切相关。干燥综合征应被视为蛋白丢失性肠病的一个病因。99m锝标记白蛋白腹部闪烁扫描有助于诊断该病、定位蛋白丢失部位及监测治疗效果，尤其是在胃发生蛋白丢失的病例中。
