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[Early and lasting remission of protein-losing enteropathy with corticosteroids]
Eric Dupont1, Anne Cleuziou, Jean-Pierre Gendre
1Service de Médecine Interne 4, Hôpital de la Cavale Blanche, CHU Brest, 29609 Brest.
Objective:
To emphasize the possibility of obtaining good quality and lasting remission of a severe idiopathic protein-loosing enteropathy with corticosteroid therapy.
Observation:
A 30 year-old woman was hospitalized for edema of the lower limbs related to hypoalbuminemia due to a protein-loosing enteropathy, demonstrated by measurement of alpha-1 antitrypsin clearance. Diagnosis of lupus was evoked but not confirmed. Nutritional treatment failed. Corticosteroids administered in a bolus, and subsequently per os, rapidly led to complete, lasting (22 months later) remission.
Discussion:
Corticosteroid therapy is the classical treatment of a protein-loosing enteropathy concomitant to disseminated lupus erythematosus, a rare combination. In the absence of lupus, a few cases of remission from a protein-loosing enteropathy have been reported. However, the delay before remission was longer than in our case report, and the remission-free period generally shorter.
Conclusion:
Corticosteroid therapy is an effective treatment of an idiopathic protein-loosing enteropathy.