Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Provincial Key Laboratory of Geriatric Diseases, Fujian Medical University, Fuzhou, China.
J Int Med Res. 2020 Feb;48(2):300060519874543. doi: 10.1177/0300060519874543. Epub 2019 Oct 8.
Protein-losing gastroenteropathy (PLGE) is a rare manifestation of primary Sjögren's syndrome that is most commonly reported in Japan. Herein, the case of a 71-year-old Chinese male patient, diagnosed with PLGE and Sjögren's syndrome, is reported. The patient presented with peripheral oedema, and PLGE was diagnosed based on the result of technetium-99m (Tc)-labelled albumin scintigraphy. In addition to a positive Schirmer's test, the patient had atrophy of the salivary gland with lymphocyte infiltration, impaired parotid-gland secretory and excretory function, and an increased level of anti-SSA antibodies, fulfilling the criteria for Sjögren's syndrome. He was successfully treated with methylprednisolone. Follow-up Tc-labelled albumin scintigraphy results correlated well with clinical improvement and increased serum albumin levels. The present case study highlights the necessity of considering a diagnosis of protein loss enteropathy associated with primary Sjögren's syndrome when patients have unexplained hypoproteinaemia.
蛋白丢失性胃肠病（PLGE）是原发性干燥综合征的一种罕见表现，在日本最为常见。本文报道了 1 例 71 岁的中国男性患者，该患者被诊断为 PLGE 和干燥综合征。患者表现为外周水肿，根据锝-99m（Tc）-标记白蛋白闪烁扫描结果诊断为 PLGE。除了 Schirmer 试验阳性外，患者还出现唾液腺萎缩伴淋巴细胞浸润、腮腺分泌和排泄功能受损以及抗 SSA 抗体水平升高，符合干燥综合征的诊断标准。他接受甲基强的松龙治疗后病情得到缓解。后续 Tc 标记白蛋白闪烁扫描结果与临床改善和血清白蛋白水平升高相关。本病例研究强调，当患者出现不明原因的低蛋白血症时，应考虑诊断与原发性干燥综合征相关的蛋白丢失性肠病。
