Frexinos J, Rumeau J L, Fortas L, Douchez J, Ribet A
Sem Hop. 1975 Jan 14;51(3):177-84.
The authors report two cases of exsudative enteropathy characterised by the existence of oedema of the lower limbs associated with hypoproteinemia and marked lymphopenia with disturbances of the P.V.P. test. In both cases lymphography demonstrated major abnormalities with obvious obstruction in one case, and signs of slowing of lymph flow with appearances of dysplasia in the other. Surgery permitted us in one case, to discover a calcified lymph node probably due to tuberculosis. The etiology of these cases is discussed and seems to be mainly related to abnormalities of the lymphatic system. A low fat diet and administration of medium-chain triglycerides, gave an undoubted improvement when the treatment was followed by the patient. These two cases illustrate well the difficult diagnostic and therapeutic problems sometimes raised by syndromes of exsudative enteropathy, in particular owing to the many possible causes.
作者报告了两例渗出性肠病病例,其特征为下肢水肿伴低蛋白血症,以及明显的淋巴细胞减少伴血浆蛋白异常试验异常。在这两例病例中,淋巴造影均显示出严重异常,其中一例有明显梗阻,另一例有淋巴流动减慢的迹象及发育异常表现。手术使我们在一例病例中发现了一个可能因结核导致的钙化淋巴结。对这些病例的病因进行了讨论,其病因似乎主要与淋巴系统异常有关。当患者遵循低脂饮食并服用中链甘油三酯时,病情有了明显改善。这两例病例很好地说明了渗出性肠病综合征有时所引发的诊断和治疗难题,尤其是由于可能的病因众多。