Tsourdi Elena, Heidrich Felix M, Winzer Maria, Röllig Christoph, Kirsch Christian, Meinel Jörn, Baretton Gustavo B, Bornstein Stefan R, Hofbauer Lorenz C
Department of Endocrinology, Diabetes and Bone Diseases, University Clinic Dresden, Dresden, Germany.
Department of Internal Medicine and Cardiology, Herzzentrum University Hospital, University Clinic Dresden, Dresden, Germany.
Am J Case Rep. 2014 May 22;15:226-9. doi: 10.12659/AJCR.890483. eCollection 2014.
Male, 50 FINAL DIAGNOSIS: Exudative enteropathy Symptoms: Abdominal pain • diarrhea • fever • hyponatremia • lymphadenopathy • weight loss
Unusual clinical course.
Protein-losing enteropathy is a rare cause of hypoproteinemia. Erosive and non-erosive gastrointestinal diseases as well as vascular disorders that result in increased central venous pressure or mesenteric lymphatic obstruction may result in protein loss via the gastrointestinal tract.
We present the case of a 50-year-old man with protein-losing enteropathy, who had profuse diarrhea, abdominal pain, lymphadenopathy, fever, and a weight loss of 10 kg in the preceding 2 months. Extensive work-up revealed infection with Giardia lamblia. We review clinical signs and symptoms, laboratory findings, and imaging studies, and discuss potential pitfalls in establishing the diagnosis.
To the best of our knowledge, this represents one of the few published cases of intestinal giardiasis as a cause of protein-losing enteropathy in an immunocompetent adult. The diagnosis of lambliasis should be based on a combination of stool cultures and serum serology, and in cases of high clinical suspicion, an endoscopy and biopsy of the upper GI tract is recommended.
男性，50岁
渗出性肠病
腹痛、腹泻、发热、低钠血症、淋巴结病、体重减轻
不寻常的临床病程。
蛋白丢失性肠病是低蛋白血症的罕见病因。糜烂性和非糜烂性胃肠道疾病以及导致中心静脉压升高或肠系膜淋巴梗阻的血管疾病可能导致蛋白质通过胃肠道丢失。
我们报告一例50岁患有蛋白丢失性肠病的男性病例，该患者在过去2个月出现大量腹泻、腹痛、淋巴结病、发热及体重减轻10千克。全面检查发现感染蓝氏贾第鞭毛虫。我们回顾临床体征和症状、实验室检查及影像学研究，并讨论诊断过程中的潜在陷阱。
据我们所知，这是为数不多的已发表病例之一，即免疫功能正常的成年人中肠道贾第虫病作为蛋白丢失性肠病的病因。贾第虫病的诊断应基于粪便培养和血清学检查相结合，对于临床高度怀疑的病例，建议进行上消化道内镜检查和活检。
