An exotic cause of exudative enteropathy

Area of Science:

• Gastroenterology
• Infectious Diseases
• Internal Medicine

Background:

• Protein-losing enteropathy is a rare condition leading to hypoproteinemia.
• It can result from various gastrointestinal diseases or vascular issues affecting lymphatic drainage.
• Causes include erosive/non-erosive diseases and conditions increasing central venous pressure.

Purpose of the Study:

• To report an unusual clinical course of protein-losing enteropathy.
• To highlight Giardia lamblia as a causative agent in an immunocompetent adult.
• To review diagnostic approaches and potential challenges.

Main Methods:

• Case presentation of a 50-year-old male with severe symptoms including diarrhea, pain, fever, and weight loss.
• Extensive diagnostic work-up to identify the underlying cause.
• Review of clinical signs, symptoms, laboratory findings, and imaging studies.

Main Results:

• The patient presented with symptoms consistent with exudative enteropathy, including abdominal pain, diarrhea, fever, hyponatremia, lymphadenopathy, and significant weight loss.
• Extensive investigations revealed an infection with Giardia lamblia as the cause.
• This case highlights intestinal giardiasis as a cause of protein-losing enteropathy.

Conclusions:

• Intestinal giardiasis is an uncommon cause of protein-losing enteropathy in immunocompetent adults.
• Diagnosis should combine stool cultures and serum serology.
• Endoscopy with biopsy is recommended when clinical suspicion for lambliasis is high.