Protein-Losing Enteropathy Associated With Arsenic Poisoning

Abstract

An 8-year-11-month-old girl had protei n\x=req-\ losing enteropathy associated with arsenic poisoning; to our knowledge, this is the first such case to be reported. A total dose of about 31 mg of arsenic trioxide was given orally during a two-month period for verrucae planae juveniles of the dorsal surface of the hands. About four weeks later edema, especially of the legs and eyelids, was noted. Jejunal biopsy with a Crosby's capsule revealed an abnormal dilated villus and mild atrophy of the submucosa. The treatment with dimercaprol resulted in improvement of both hypoproteinemia and edema.Edema and hypoproteinemia re¬ sulting from protein loss into the gastrointestinal tract has been de¬ scribed in patients with a wide varie¬ ty of gastrointestinal lesions, as well as in patients with such diseases as congestive heart failure, nephrosis, and dermatitis herpetiformis. Since reliable methods for quantification of protein loss into the gut have been described, more than 40 disorders have been shown to be potentially associated with an abnormally high leakage of protein into the gastroin¬ testinal tract. Therefore, the proteinlosing enteropathy is not a disease entity, but a syndrome with numer¬ ous underlying causes.

Enteraler Eiweißverlust: Pathophysiologie, Ursachen, Diagnostik und Therapie mit Fallbeispielen

“…Perikarditis konstrictiva [59,61,84] Fontan-Zirkulation [18,34] Störungen im Abfluss des Mesenterialgefäûbettes Budd-Chiari-Syndrom (erworben oder aut.-rezessiv; OMIM 226300) [76] Mesenterialvenenthrombose [35] Lupus erythematodes [64,85,89] Purpura Schönlein Hennoch [69] Neurofibromatose mit Beteiligung von Mesenterialgefäûen [81] diffuses Angiokeratom (M. Fabry; OMIM 301500) [28] Obstruktion von Lymphgefäûen Malrotation Briden Neoplasien (Lymphome [13,77], Langerhanszellhistiozytose [80], lymphoproliferative Erkrankung n. Transplantation [95]) zystisches Lymphangiomyom [98] Tuberkulose Sarkoidose [51,68] Bestrahlungsschäden [71] Intoxikationen (Arsen [44]; Quecksilber [43])…”