Published online Apr 28, 2017. doi: 10.3748/wjg.v23.i16.3003
Peer-review started: February 3, 2017
First decision: February 23, 2017
Revised: March 11, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: April 28, 2017
Processing time: 91 Days and 5 Hours
Protein-losing enteropathy (PLE) is characterized by loss of serum proteins into the gastrointestinal tract. It may lead to hypoproteinemia and clinically present as protein deficiency edema, ascites, pleural or pericardial effusion and/or malnutrition. In most cases the site of protein loss is the small intestine. Here we present an unusual case of severe PLE in a 55-year old female with a one-year history of recurrent diarrhea, crampy abdominal pain, and peripheral edema. Endoscopy and MRI showed a diffuse inflammatory thickening of the sigmoid colon and the rectum. Surgical resection of the involved colon was performed and the symptoms were significantly resolved. The final histologic evaluation confirmed a diagnosis of a pseudomembranous colitis with cap polyposis-like features. Such a cause of PLE has never been described before.
Core tip: Protein-losing enteropathy (PLE) is characterized by loss of serum proteins into the gastrointestinal tract. The small intestine is the most common site of protein loss. This is an unusual case of severe PLE involving the sigmoid colon and the rectum. Surgical resection was performed and subsequent histologic evaluation confirmed a diagnosis of a pseudomembranous colitis with cap polyposis-like features.