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Intestinal Lymphangiectasia With Response to Corticosteroids

Intestinal Lymphangiectasia With Response to Corticosteroids Abstract IN 1957 Citrin et al1 demonstrated that the stomach of a patient with giant rugal hypertrophy could be the site of protein loss sufficiently large to cause hypoalbuminemia. Subsequent studies revealed that a number of diseases affecting various portions of the gastrointestinal tract could be responsible also.2-4 A syndrome of enteric leakage of protein associated with characteristic dilated small intestinal mucosal lymphatics (intestinal lymphangiectasia) was described by Waldmann and associates.5 Later Pomerantz and Waldmann6 demonstrated widespread involvement of lymphatics in this syndrome. Hypoplasia of the lymphatic vessels of the lower extremities, abnormalities of the pelvic and abdominal lymphatics, and anomalies of the thoracic duct were found. Generally, it is held4,5 that corticosteroids have no effect on the clinical course of patients with intestinal lymphangiectasia. The present case appeared to be benefited by long-term corticosteroid therapy. Report of Case A 13-year-old white school girl was seen at Confederate Memorial Medical Center References 1. Citrin, Y.; Sterling, K.; and Holman, H.A.: The Mechanism of Hypoproteinemia Associated With Giant Hypertrophy of the Gastric Mucosa , New Eng J Med 257:906-912, 1957.Crossref 2. Gordon, R.S., Jr.: Exudative Enteropathy: Abnormal Permeability of the Gastrointestinal Tract Demonstrable With Labelled Polyvinylpyrrolidone , Lancet 1:325-326, 1959.Crossref 3. Steinfeld, J.L., et al: The Mechanism of Hypoproteinemia in Patients With Regional Enteritis and Ulcerative Colitis , Amer J Med 29:405-415, 1960.Crossref 4. Kaiser, M.H.: " Protein-Losing Gastroenteropathy ," in Bockus, H.L. (ed.): Gastroenterology , ed 2, Philadelphia: W. B. Saunders Company, 1964, pp 510-529. 5. Waldmann, T. A., et al: The Role of Gastrointestinal System in "Idiopathic Hypoproteinemia," Gastroenterology 41:197-207, 1961. 6. Pomerantz, M., and Waldmann, T.A.: Systemic Lymphatic Abnormalities Associated With Gastrointestinal Protein Loss Secondary to Intestinal Lymphangiectasia , Gastroenterology 45:703-711, 1963. 7. Gordon, R.S., Jr.; Waldmann, T.; and Laster, L.: " Protein-Losing Gastroenteropathy ," in Dowling, H.F. (ed.): Disease-a-Month , Chicago: Year Book Medical Publishers, Inc., 1966, pp 12-14. 8. Milhaud, G., and Vesin, P.: Calcium Metabolism in Man With Calcium-45: Malabsorption Syndrome and Exudative Enteropathy , Nature 191:872-874, 1961.Crossref 9. Jeffries, G.H.; Chapman, A.; and Sleisenger, M.H.: Low-Fat Diet in Intestinal Lymphangiectasia: Its Effect on Albumin Metabolism , New Eng J Med 270:761-766, 1964.Crossref 10. Holt, P.R.: Dietary Treatment of Protein Loss in Intestinal Lymphangiectasia , Pediatrics 34:629-635, 1964. 11. Vesica, G.G., and Davis, J.H.: Treatment of Intestinal Lymphangiectasia, Comments , Gastroenterology 48:287, 1965. 12. Sheehy, T.W., et al: Hookworm Disease and Malabsorption , Gastroenterology 42:148-156, 1962. 13. Whitmore, D.N.; Gresham, G.A.; and Grayson, M.J.: Nocardiosis in Anemic Patients Given Steroids , J Clin Path 14:259-263, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Intestinal Lymphangiectasia With Response to Corticosteroids

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00290200130014
Publisher site
See Article on Publisher Site

Abstract

Abstract IN 1957 Citrin et al1 demonstrated that the stomach of a patient with giant rugal hypertrophy could be the site of protein loss sufficiently large to cause hypoalbuminemia. Subsequent studies revealed that a number of diseases affecting various portions of the gastrointestinal tract could be responsible also.2-4 A syndrome of enteric leakage of protein associated with characteristic dilated small intestinal mucosal lymphatics (intestinal lymphangiectasia) was described by Waldmann and associates.5 Later Pomerantz and Waldmann6 demonstrated widespread involvement of lymphatics in this syndrome. Hypoplasia of the lymphatic vessels of the lower extremities, abnormalities of the pelvic and abdominal lymphatics, and anomalies of the thoracic duct were found. Generally, it is held4,5 that corticosteroids have no effect on the clinical course of patients with intestinal lymphangiectasia. The present case appeared to be benefited by long-term corticosteroid therapy. Report of Case A 13-year-old white school girl was seen at Confederate Memorial Medical Center References 1. Citrin, Y.; Sterling, K.; and Holman, H.A.: The Mechanism of Hypoproteinemia Associated With Giant Hypertrophy of the Gastric Mucosa , New Eng J Med 257:906-912, 1957.Crossref 2. Gordon, R.S., Jr.: Exudative Enteropathy: Abnormal Permeability of the Gastrointestinal Tract Demonstrable With Labelled Polyvinylpyrrolidone , Lancet 1:325-326, 1959.Crossref 3. Steinfeld, J.L., et al: The Mechanism of Hypoproteinemia in Patients With Regional Enteritis and Ulcerative Colitis , Amer J Med 29:405-415, 1960.Crossref 4. Kaiser, M.H.: " Protein-Losing Gastroenteropathy ," in Bockus, H.L. (ed.): Gastroenterology , ed 2, Philadelphia: W. B. Saunders Company, 1964, pp 510-529. 5. Waldmann, T. A., et al: The Role of Gastrointestinal System in "Idiopathic Hypoproteinemia," Gastroenterology 41:197-207, 1961. 6. Pomerantz, M., and Waldmann, T.A.: Systemic Lymphatic Abnormalities Associated With Gastrointestinal Protein Loss Secondary to Intestinal Lymphangiectasia , Gastroenterology 45:703-711, 1963. 7. Gordon, R.S., Jr.; Waldmann, T.; and Laster, L.: " Protein-Losing Gastroenteropathy ," in Dowling, H.F. (ed.): Disease-a-Month , Chicago: Year Book Medical Publishers, Inc., 1966, pp 12-14. 8. Milhaud, G., and Vesin, P.: Calcium Metabolism in Man With Calcium-45: Malabsorption Syndrome and Exudative Enteropathy , Nature 191:872-874, 1961.Crossref 9. Jeffries, G.H.; Chapman, A.; and Sleisenger, M.H.: Low-Fat Diet in Intestinal Lymphangiectasia: Its Effect on Albumin Metabolism , New Eng J Med 270:761-766, 1964.Crossref 10. Holt, P.R.: Dietary Treatment of Protein Loss in Intestinal Lymphangiectasia , Pediatrics 34:629-635, 1964. 11. Vesica, G.G., and Davis, J.H.: Treatment of Intestinal Lymphangiectasia, Comments , Gastroenterology 48:287, 1965. 12. Sheehy, T.W., et al: Hookworm Disease and Malabsorption , Gastroenterology 42:148-156, 1962. 13. Whitmore, D.N.; Gresham, G.A.; and Grayson, M.J.: Nocardiosis in Anemic Patients Given Steroids , J Clin Path 14:259-263, 1961.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1967

References