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Protein losing enteropathy as a manifestation of Henoch-Schönlein purpura
1Department of Gastroenterology and Nutrition, Children's Hospital of Buffalo, New York.
Insights
Henoch-Schönlein purpura (HSP) can cause severe intestinal protein loss, leading to edema. Corticosteroid therapy effectively resolved this protein-losing enteropathy in a pediatric case.
Area of Science:
- Pediatric Gastroenterology
- Nephrology
- Immunology
Background:
- Henoch-Schönlein purpura (HSP) is a systemic vasculitis often affecting the gastrointestinal tract and kidneys.
- Gastrointestinal symptoms like pain and bleeding are common, but severe protein loss leading to edema is less frequently highlighted.
Observation:
- A 14-year-old boy presented with classical HSP features, including significant edema.
- Edema was attributed to severe protein-losing enteropathy, confirmed by elevated fecal alpha 1 antitrypsin levels.
Findings:
- The study demonstrates a direct link between HSP and severe intestinal protein loss causing edema.
- Measurement of fecal alpha 1 antitrypsin secretion is a valuable tool for diagnosing protein-losing enteropathy in HSP.
Implications:
- This case highlights the importance of considering severe protein-losing enteropathy in HSP patients presenting with edema.
- Corticosteroid treatment appears effective in managing HSP-associated protein-losing enteropathy, potentially preventing further complications.
Abstract:
Gastrointestinal manifestations of Henoch-Schönlein purpura (HSP) commonly include abdominal pain and gastrointestinal bleeding. Hypoproteinemia and edema could be related to renal involvement. We report a 14-year-old boy with classical features of HSP manifestated with edema due to severe intestinal protein loss, measured by elevated fecal alpha 1 antitrypsin secretion. The protein losing enteropathy subsided with corticosteroid therapy.