Exudative enteropathy in neonates: A case report

Abstract

The term exudative gastroenteropathy is used to describe an entity characterized by excessive loss of plasma proteins in the gastrointestinal tract. This digestive exudation can be caused either by an obstacle to intestinal lymphatic drainage or by an alteration of the epithelial barrier. The clinical picture is often associated with chronic diarrhea and an edematous syndrome. Lymphedema, infectious complications secondary to lymphopenia or hypogammaglobulinemia, and thromboembolic complications may also be observed. Diagnosis is based on the measurement of fecal alpha-1 antitrypsin clearance. Sometimes primary in the context of Waldmann disease (primary intestinal lymphangiectasis) but more often secondary. It requires an endoscopic and morphological workup to confirm the origin of the protein leak, to evaluate its extent and cause. In addition to etiological treatment, management is based on a hyperprotein and hypolipid diet with medium-chain triglyceride supplementation. We report the case of an exudative enteropathy in a newborn.