Shende Prakash, Vadivel Subashini, Nandha Kishore Sheetal, Sanghani Dhairya
General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Cureus. 2024 Jul 30;16(7):e65745. doi: 10.7759/cureus.65745. eCollection 2024 Jul.
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.
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。