Evaluation of paediatric patients with protein losing enteropathy a single centre experience
N Urganci1, S G Gulec2, D Kalyoncu2
1Department of Paediatric Gastroenterology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Insights
Protein losing enteropathy (PLE) in children can stem from various causes like celiac disease or infections. Prompt diagnosis and targeted treatment are key for managing this condition effectively.
Area of Science:
- Pediatric Gastroenterology
- Internal Medicine
Background:
- Protein losing enteropathy (PLE) is a complex condition characterized by excessive protein loss into the gastrointestinal tract.
- Understanding the diverse etiologies and clinical presentations of PLE in pediatric populations is crucial for effective management.
Purpose of the Study:
- To evaluate pediatric patients diagnosed with protein losing enteropathy (PLE).
- To analyze the etiologies, diagnostic approaches, laboratory findings, treatment strategies, and long-term outcomes of pediatric PLE cases.
Main Methods:
- Retrospective evaluation of fourteen pediatric patients diagnosed with PLE.
- Assessment of underlying causes, diagnostic methods employed, laboratory results, treatment regimens, and patient prognoses.
Main Results:
- Identified etiologies included celiac disease (4 cases), intestinal lymphangiectasia (3 cases), giardia infection (3 cases), H pylori infection (1 case), and cytomegalovirus (CMV) infection (3 cases).
- Histopathological findings varied, with total villous atrophy, lymphatic dilatation, and nodular appearance noted in duodenal biopsies.
- Most cases achieved remission with treatment targeting the underlying cause; CMV infections were managed with supportive care, avoiding ganciclovir.
Conclusions:
- Protein losing enteropathy (PLE) should be considered in well-appearing children presenting with edema, even in the absence of proteinuria.
- Timely diagnosis and appropriate treatment of the underlying condition are essential for favorable outcomes in pediatric PLE.
Objective:
The aim of the study is to evaluate paediatric patients with protein losing enteropathy (PLE).
Methods:
Fourteen cases diagnosed as PLE were evaluated in terms ofaetiologies, diagnostic methods, laboratory findings, treatment procedures and long-term prognosis.
Results:
Four of the cases had coeliac disease, three intestinal lymphangiectasia, three giardia infection, one H pylori infection and three cytomegalovirus (CMV) infection. Histopathological examinations of duodenum specimens revealed total villous atrophy in four cases, lymphatic dilatation in three cases, severe nodular appearance in four cases and no pathology in four cases. All of the cases except patients with intestinal lymphangiectasia were controlled by the appropriate treatment given for the underlying disease. The cases with CMV infection were treated with only supportive treatment and gancyclovir therapy was not needed.
Conclusion:
When proteinuria is not detected in well-appearing children admitted with oedema, PLE must be considered.
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