[Protein-losing gastroenteropathies in children. Clinical, laboratory and therapeutic observations in 13 patients].

Thirteen children carrying protein-losing gastroenteropathy confirmed by the excretion fecal 51Cr albumin are presented. The ages ranged from 3 months to 12 years old, and the mean age of onset of symptom was 6 years 11 months old. Symptoms initiated between 3 to 7 years old in 11 patients. First and second grade malnutrition were detected within 10 cases. The most frequent clinical observation was diarrhea, found in 11 patients, followed by peripheral edema (10), anorexia (10), paleness (10), muscular hypotrophy (9), abdominal distension (8), ascite (7), wasted (7) and vomiting (5). The serum albumin level was below 2.5 g/100 ml in 12 patients, with and average of 1.7 g/100 ml. The gammaglobulin fraction was below 1.0 g/100 ml in 8 patients and lymphocytopenia in 5. Tests have shown a compromised fat absorption, thus, 7 among 8 lipiodol's test were negatives. The etiologic diagnosis were: paracoccidioidomycoses (5 patients), primary enteric lymphangiectasia (1), stronglyoidiasis (1), constrictive pericarditis (1), rheumatic carditis with double mitral lesion (1), Ménétrier's disease (1), short gut malabsorption syndrome (1), celiac disease (1) and cow's milk allergy (1). The responsible mechanism for the great loss of proteins to the digestive tube as well as diagnose and therapeutic aspects of the patients are commented. A report of 4 cases was done, as a way to show the pathology more characteristically due to protein losing gastroenteropathy.