Protein-Losing Enteropathy Questions & Answers

1. Lee YT, Sung JJ. Protein-losing enteropathy. Gastrointest Endosc. 2004 Nov. 60(5):801-2. [QxMD MEDLINE Link].

2. Laine L, Garcia F, McGilligan K, et al. Protein-losing enteropathy and hypoalbuminemia in AIDS. AIDS. 1993 Jun. 7(6):837-40. [QxMD MEDLINE Link].

3. Waldmann TA, Wochner RD, Strober W. The role of the gastrointestinal tract in plasma protein metabolism. Studies with 51Cr-albumin. Am J Med. 1969 Feb. 46(2):275-85. [QxMD MEDLINE Link].

4. Rybolt AH, Bennett RG, Laughon BE, et al. Protein-losing enteropathy associated with Clostridium difficile infection. Lancet. 1989 Jun 17. 1(8651):1353-5. [QxMD MEDLINE Link].

5. Akgun A, Tani Acar E, Taner MS, et al. Scintigraphic diagnosis of protein-losing enteropathy secondary to amyloidosis. Turk J Gastroenterol. 2005 Mar. 16(1):41-3. [QxMD MEDLINE Link].

6. Cheong JL, Cowan FM, Modi N. Gastrointestinal manifestations of postnatal cytomegalovirus infection in infants admitted to a neonatal intensive care unit over a five year period. Arch Dis Child Fetal Neonatal Ed. 2004 Jul. 89(4):F367-9. [QxMD MEDLINE Link].

7. Pratz KW, Dingli D, Smyrk TC, et al. Intestinal lymphangiectasia with protein-losing enteropathy in Waldenstrom macroglobulinemia. Medicine (Baltimore). 2007 Jul. 86(4):210-4. [QxMD MEDLINE Link].

8. Venkatesh B, Gough J, Ralston DR, et al. Protein losing enteropathy in critically ill adult patients with burns: a preliminary report. Intensive Care Med. 2004 Jan. 30(1):162-6. [QxMD MEDLINE Link].

9. Citrin Y, Sterling K, Halsted JA. The mechanism of hypoproteinemia associated with giant hypertrophy of the gastric mucosa. N Engl J Med. 1957 Nov 7. 257(19):906-12. [QxMD MEDLINE Link].

10. Overholt BF, Jeffries GH. Hypertrophic, hypersecretory protein-losing gastropathy. Gastroenterology. 1970 Jan. 58(1):80-7. [QxMD MEDLINE Link].

11. Fretzayas A, Moustaki M, Alexopoulou E, Nicolaidou P. Menetrier's disease associated with Helicobacter pylori: three cases with sonographic findings and a literature review. Ann Trop Paediatr. 2011. 31(2):141-7. [QxMD MEDLINE Link].

12. Ito R, Sakagami J, Kataoka K, et al. Chronic diarrhea and protein-losing gastroenteropathy caused by Dientamoeba fragilis. J Gastroenterol. 2004 Nov. 39(11):1117-9. [QxMD MEDLINE Link].

13. Murali A, Narasimhan D, Krishnaveni J, Rajendiran G. Protein losing enteropathy in systemic lupus erythematosus. J Assoc Physicians India. 2013 Oct. 61(10):747-9. [QxMD MEDLINE Link].

14. Lim DH, Kim YG, Bae SH, et al. Factors related to outcomes in lupus-related protein-losing enteropathy. Korean J Intern Med. 2015 Nov. 30(6):906-12. [QxMD MEDLINE Link].

15. Naddei R, Orlando F, Aloj G, De Matteis A, Alessio M. Differential diagnosis of hypoalbuminemia in childhood: protein losing enteropathy associated to systemic lupus erythematosus in a young boy. Eur J Gastroenterol Hepatol. 2020 Jan. 32(1):127-9. [QxMD MEDLINE Link].

16. Ng DM, Sek K, Nossent J. Protein-losing enteropathy as a rare manifestation of systemic lupus erythematosus. BMJ Case Rep. 2023 Aug 27. 16 (8):[QxMD MEDLINE Link]. [Full Text].

17. Vyas H, Driscoll DJ, Cetta F, et al. Gastrointestinal bleeding and protein-losing enteropathy after the Fontan operation. Am J Cardiol. 2006 Sep 1. 98(5):666-7. [QxMD MEDLINE Link].

18. John AS, Johnson JA, Khan M, et al. Clinical outcomes and improved survival in patients with protein-losing enteropathy after the Fontan operation. J Am Coll Cardiol. 2014 Jul 8. 64(1):54-62. [QxMD MEDLINE Link].

19. Dori Y, Keller MS, Fogel MA, et al. MRI of lymphatic abnormalities after functional single-ventricle palliation surgery. AJR Am J Roentgenol. 2014 Aug. 203(2):426-31. [QxMD MEDLINE Link].

20. Al Balushi A, Mackie AS. Protein-losing enteropathy following Fontan palliation. Can J Cardiol. 2019 Dec. 35(12):1857-60. [QxMD MEDLINE Link].

21. Patel JK, Loomes KM, Goldberg DJ, Mercer-Rosa L, Dodds K, Rychik J. Early impact of Fontan operation on enteric protein loss. Ann Thorac Surg. 2016 Mar. 101(3):1025-30. [QxMD MEDLINE Link].

22. Sharma VJ, Iyengar AJ, Zannino D, et al. Protein-losing enteropathy and plastic bronchitis after the Fontan procedure. J Thorac Cardiovasc Surg. 2021 Jun. 161 (6):2158-65.e4. [QxMD MEDLINE Link]. [Full Text].

23. Waldmann TA. Protein-losing enteropathy. Gastroenterology. 1966 Mar. 50(3):422-43. [QxMD MEDLINE Link].

24. Chau TN, Mok MY, Chan EY, et al. Evaluation of performance of measurement of faecal a(1)-antitrypsin clearance and technetium-99m human serum albumin scintigraphy in protein-losing enteropathy. Digestion. 2011. 84(3):199-206. [QxMD MEDLINE Link].

25. Furfaro F, Bezzio C, Maconi G. Protein-losing enteropathy in inflammatory bowel diseases. Minerva Gastroenterol Dietol. 2015 Dec. 61(4):261-5. [QxMD MEDLINE Link].

26. Murray FR, Morell B, Biedermann L, Schreiner P. Protein-losing enteropathy as precursor of inflammatory bowel disease: a review of the literature. BMJ Case Rep. 2021 Jan 11. 14 (1):[QxMD MEDLINE Link]. [Full Text].

27. Edwards K, Yearsley K. Unusual presentation of Crohn's disease. BMJ Case Rep. 2021 Jun 9. 14 (6):[QxMD MEDLINE Link]. [Full Text].

28. Bindl L, Buderus S, Bindl C, Lentze MJ. Protein-losing enteropathy: report of four cases and review of etiology, diagnostic work-up and treatment. Klin Padiatr. 2005. 217:201-10.

29. Florent C, L'Hirondel C, Desmazures C, et al. Intestinal clearance of alpha 1-antitrypsin. A sensitive method for the detection of protein-losing enteropathy. Gastroenterology. 1981 Oct. 81(4):777-80. [QxMD MEDLINE Link].

30. Magdo HS, Stillwell TL, Greenhawt MJ, et al. Immune abnormalities in Fontan protein-losing enteropathy: a case-control study. J Pediatr. 2015 Aug. 167(2):331-7. [QxMD MEDLINE Link].

31. Albright F, Bartter FC, Forbes AP. The fate of human serum albumin administered intravenously to a patient with idiopathic hypoalbuminemia and hypoproteinemia. Trans Assoc Am Physicians. 1949. 204:62.

32. Ferrante M, De Hertogh G, Penninckx F, et al. Protein-losing enteropathy in Crohn's disease. Clin Gastroenterol Hepatol. 2005 Jun. 3(6):A25. [QxMD MEDLINE Link].

33. Stark ME, Batts KP, Alexander GL. Protein-losing enteropathy with collagenous colitis. Am J Gastroenterol. 1992 Jun. 87(6):780-3. [QxMD MEDLINE Link].

34. Ozeki T, Ogasawara N, Izawa S, et al. Protein-losing enteropathy associated with collagenous colitis cured by withdrawal of a proton pump inhibitor. Intern Med. 2013. 52(11):1183-7. [QxMD MEDLINE Link].

35. Nakaya Y, Kaku Hosokawa S, Kataoka Y, et al. Acute onset collagenous colitis associated with protein-losing enteropathy. J Gen Fam Med. 2017 Jun. 18(3):135-8. [QxMD MEDLINE Link]. [Full Text].

36. US Food and Drug Administration. FDA approves first treatment for CD55-deficient protein-losing enteropathy (CHAPLE disease). Available at https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-first-treatment-cd55-deficient-protein-losing-enteropathy-chaple-disease. August 18, 2023; Accessed: August 29, 2023.

37. Ozen A, Chongsrisawat V, Sefer AP, and the, Pozelimab CHAPLE Working Group. A phase 2/3 study evaluating the efficacy and safety of pozelimab in patients with CD55 deficiency with hyperactivation of complement, angiopathic thrombosis, and protein-losing enteropathy (CHAPLE disease). Lancet (preprint). 2023 Jul 27. [Full Text].

38. Jeffries GH, Chapman A, Sleisenger MH. Low-fat diet in intestinal lymphangiectasia. Its effect on albumin metabolism. N Engl J Med. 1964 Apr 9. 270:761-6. [QxMD MEDLINE Link].

39. Lee HJ, Rha MY, Cho YY, Kim ER, Chang DK. A case of protein supplement effect in protein-losing enteropathy. Clin Nutr Res. 2012 Jul. 1(1):94-8. [QxMD MEDLINE Link]. [Full Text].

40. Yeaton P, Frierson HF Jr. Octreotide reduces enteral protein losses in Ménétrier's disease. Am J Gastroenterol. 1993 Jan. 88(1):95-8. [QxMD MEDLINE Link].

41. Levitt DG, Levitt MD. Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states. Clin Exp Gastroenterol. 2017. 10:147-68. [QxMD MEDLINE Link]. [Full Text].

42. Kylat RI, Witte MH, Barber BJ, Dori Y, Ghishan FK. Resolution of protein-losing enteropathy after congenital heart disease repair by selective lymphatic embolization. Pediatr Gastroenterol Hepatol Nutr. 2019 Nov. 22(6):594-600. [QxMD MEDLINE Link].

Naeem Aslam, MD Fellow, Department of Medicine, Division of Gastroenterology/Hepatology, University of Louisville School of Medicine

Naeem Aslam, MD is a member of the following medical societies: American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Richard Wright, MD Professor and Chief, Department of Medicine, Division of Gastroenterology/Hepatology, University of Louisville School of Medicine

Richard Wright, MD is a member of the following medical societies: American Association for Physician Leadership, American College of Physicians, American Gastroenterological Association, American Medical Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Burt Cagir, MD, FACS Associate Regional Dean and Professor of Surgery, Geisinger Commonwealth School of Medicine; Director, General Surgery Residency Program, Executive Director, Donald Guthrie Foundation for Research and Education, Guthrie Robert Packer Hospital; Medical Director, Guthrie/RPH Skills and Simulation Lab; Associate in Surgery, Guthrie Robert Packer Hospital and Corning Hospital

Burt Cagir, MD, FACS is a member of the following medical societies: American College of Surgeons, Association of Program Directors in Surgery, Society for Surgery of the Alimentary Tract

Disclosure: Nothing to disclose.

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