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一名年轻女性因蛋白丢失性肠病继发全身性水肿,最终诊断为胃肠道神经内分泌肿瘤:来自印度郊区的病例报告

Anasarca Secondary to Protein-Losing Enteropathy Leading to the Diagnosis of a Gastrointestinal Neuroendocrine Tumor in a Young Female: A Case Report From an Indian Suburb.

作者信息

Shende Prakash, Vadivel Subashini, Nandha Kishore Sheetal, Sanghani Dhairya

机构信息

General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.

出版信息

Cureus. 2024 Jul 30;16(7):e65745. doi: 10.7759/cureus.65745. eCollection 2024 Jul.

DOI:10.7759/cureus.65745
PMID:39211694
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11361621/
Abstract

A 34-year-old woman presented with worsening generalized swelling and breathlessness for four months; physical examination showed pallor, diffuse anasarca, and bilateral crackles on respiratory auscultation. Laboratory investigations showed severe hypoproteinemia, fat malabsorption with fat-soluble vitamin deficiency, and significant protein loss in the stool. Imaging studies revealed pulmonary edema, ascites, bowel wall edema, and a duodenal polyp. Further evaluating the duodenal polyp, a grade two duodenal neuroendocrine tumor (NET) was identified. She was managed with subcutaneous octreotide and duodenal polypectomy, resulting in significant clinical improvement. This case highlights the importance of diagnosing and managing protein-losing enteropathy secondary to gastric neuroendocrine tumors.

摘要

一名34岁女性因全身肿胀和呼吸困难加重四个月前来就诊;体格检查发现面色苍白、全身水肿,呼吸听诊有双侧啰音。实验室检查显示严重低蛋白血症、脂肪吸收不良伴脂溶性维生素缺乏,粪便中有大量蛋白质丢失。影像学检查显示肺水肿、腹水、肠壁水肿和十二指肠息肉。对十二指肠息肉进一步评估后,确诊为二级十二指肠神经内分泌肿瘤(NET)。她接受了皮下注射奥曲肽和十二指肠息肉切除术治疗,临床症状得到显著改善。该病例突出了诊断和治疗胃神经内分泌肿瘤继发的蛋白丢失性肠病的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/2ecd20e647ed/cureus-0016-00000065745-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/7bba9bc1f30c/cureus-0016-00000065745-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/b7e896907c3c/cureus-0016-00000065745-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/84b280d7a365/cureus-0016-00000065745-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/957b99751cef/cureus-0016-00000065745-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/15a6e6367632/cureus-0016-00000065745-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/84fe222bf0e9/cureus-0016-00000065745-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/2ecd20e647ed/cureus-0016-00000065745-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/7bba9bc1f30c/cureus-0016-00000065745-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/b7e896907c3c/cureus-0016-00000065745-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/84b280d7a365/cureus-0016-00000065745-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/957b99751cef/cureus-0016-00000065745-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/15a6e6367632/cureus-0016-00000065745-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/84fe222bf0e9/cureus-0016-00000065745-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7260/11361621/2ecd20e647ed/cureus-0016-00000065745-i07.jpg

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本文引用的文献

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Protein-Losing Enteropathy.蛋白丢失性肠病
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A Comprehensive Review on Neuroendocrine Neoplasms: Presentation, Pathophysiology and Management.神经内分泌肿瘤综述:临床表现、病理生理学与管理
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Overview of the 2022 WHO Classification of Neuroendocrine Neoplasms.《2022 年世卫组织神经内分泌肿瘤分类概述》。
Endocr Pathol. 2022 Mar;33(1):115-154. doi: 10.1007/s12022-022-09708-2. Epub 2022 Mar 16.
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Protein-Losing Enteropathy in Crohn's Disease: Two Unusual Cases.克罗恩病中的蛋白丢失性肠病:两例罕见病例
Cureus. 2021 Nov 12;13(11):e19501. doi: 10.7759/cureus.19501. eCollection 2021 Nov.
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Lymphangiomatosis associated with protein losing enteropathy: A case report.淋巴管瘤病合并蛋白丢失性肠病:一例报告。
World J Clin Cases. 2021 May 26;9(15):3758-3764. doi: 10.12998/wjcc.v9.i15.3758.
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Differential Diagnosis of Diarrhea in Patients With Neuroendocrine Tumors.神经内分泌肿瘤患者腹泻的鉴别诊断。
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Comparative pathophysiology and management of protein-losing enteropathy.蛋白质丢失性肠病的比较病理生理学与管理
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Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states.蛋白丢失性肠病:与临床和亚临床疾病状态的机制关联的全面综述
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