Amiot A
Service d'hépato-gastroentérologie, hôpital Henri-Mondor, université Paris Est Créteil, AP-HP, 51, boulevard du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
Rev Med Interne. 2015 Jul;36(7):467-73. doi: 10.1016/j.revmed.2014.12.001. Epub 2015 Jan 21.
Protein-losing enteropathy is a rare syndrome of gastrointestinal protein loss. The primary causes can be classified into lymphatic leakage due to increased interstitial pressure and increased leakage of protein-rich fluids due to erosive or non-erosive gastrointestinal disorders. The diagnosis of protein-losing enteropathy should be considered in patients with chronic diarrhea and peripheral oedema. The diagnosis of protein-losing enteropathy is most commonly based on the determination of fecal alpha-1 antitrypsin clearance. Most protein-losing enteropathy cases are the result of either lymphatic obstruction or a variety of gastrointestinal disorders and cardiac diseases, while primary intestinal lymphangiectasia (Waldmann's disease) is less common. Treatment of protein-losing enteropathy targets the underlying disease but also includes dietary modification, such as high-protein and low-fat diet along with medium-chain triglyceride supplementation.
蛋白丢失性肠病是一种罕见的胃肠道蛋白丢失综合征。主要病因可分为因间质压力增加导致的淋巴渗漏以及因糜烂性或非糜烂性胃肠道疾病导致的富含蛋白质的液体渗漏增加。慢性腹泻和外周水肿患者应考虑蛋白丢失性肠病的诊断。蛋白丢失性肠病的诊断最常基于粪便α-1抗胰蛋白酶清除率的测定。大多数蛋白丢失性肠病病例是由淋巴阻塞或各种胃肠道疾病及心脏疾病引起的，而原发性肠淋巴管扩张症（沃尔德曼病）则较少见。蛋白丢失性肠病的治疗以潜在疾病为目标，但也包括饮食调整，如高蛋白、低脂饮食以及补充中链甘油三酯。
