Protein-Losing Enteropathy Detected on Tc-99m HSA and Tc-99m MDP Scintigraphy

Seok, Ju Won; Kim, Seong Jang; Lee, Sun Hee; Kim, In Joo; Kim, Yong Ki

doi:10.1097/00003072-200206000-00009

Cited by 18 publications

(3 citation statements)

References 6 publications

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“…The most commonly used and reliable method to determine enteric protein loss is to determine the clearance of α-1 antitrypsin (A1AT) clearance which requires both a blood sample and a 24-hr stool collection to determine plasma and stool A1AT level respectively. Recently, technetium-99m (99m Tc) labeled human albumin scintigraphy (HSA) has been shown as a useful alternative means for diagnosis as well as in monitoring response to treatment 2,3. Although 99m Tc HSA has a high sensitivity in detecting the protein leak, it has two major pitfalls in that any gastrointestinal bleeding and in vivo breakdown of 99m Tc HSA yielding free pertechnetate may result in a false-positive accumulation of enteric 99m Tc HSA activity 4.…”

Section: Discussionmentioning

confidence: 99%

A Gentleman with an Unusual Cause of Hypoalbuminemia

Law

Chiu

2012

Clin Med Insights Gastroenterol

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Protein-losing enteropathy (PLE) is a rare syndrome of gastrointestinal protein loss that may complicate a variety of diseases. The primary causes can be divided into erosive gastrointestinal disorders, nonerosive gastrointestinal disorders, and disorders involving increased central venous pressure or mesenteric lymphatic obstruction.Herein, we report on a 65-year-old man with PLE caused by invasive gastrointestinal stromal tumor (GIST). To our best knowledge, this is the first reported association between GIST and PLE. A brief review of the literature on the incidence, pathogenesis and management of GIST is also presented.

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Section: Discussionmentioning

confidence: 99%

A Gentleman with an Unusual Cause of Hypoalbuminemia

Law

Chiu

2012

Clin Med Insights Gastroenterol

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“…Recently, Tc-99m HAS scintigraphy has been used to diagnose PLE by documenting protein loss in the gut, which is also useful for monitoring response to treatment. 9–10 Our two patients were diagnosed as having PLE because of hypoalbuminemia without nephrosis or liver dysfunction, as well as abnormal leakage of the radiotracer into the gut on Tc-99m HSA scintigraphy. Tc-99m HAS scintigraphy offers a rapid, safe, and convenient way to screen and localize PLE.…”

Section: Discussionmentioning

confidence: 99%

Protein-Losing Enteropathy Associated with Henoch-Schönlein Purpura

2010

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The gastrointestinal manifestations of Henoch-Schönlein purpura include abdominal pain, gastrointestinal bleeding, intussusception, and perforation. Protein-losing enteropathy is rarely associated with Henoch-Schönlein purpura. Two pediatric patients with Henoch-Schönlein purpura who developed protein-losing enteropathy are reported. Tc-99m human serum albumin scintigraphy is useful in the detection of protein-losing enteropathy.

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“…No adverse reactions to the tracer were described. Functional imaging with Tc-99m serum albumin has been able to identify the region of protein leakage [24, 30]. …”

Section: How To Diagnose Plementioning

confidence: 99%

Clinical practice

2010

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Protein-losing enteropathy (PLE) is a rare complication of a variety of intestinal disorders characterized by an excessive loss of proteins into the gastrointestinal tract due to impaired integrity of the mucosa. The clinical presentation of patients with PLE is highly variable, depending upon the underlying cause, but mainly consists of edema due to hypoproteinemia. While considering PLE, other causes of hypoproteinemia such as malnutrition, impaired synthesis, or protein loss through other organs like the kidney, liver, or skin, have to be excluded. The disorders causing PLE can be divided into those due to protein loss from intestinal lymphatics, like primary intestinal lymphangiectasia or congenital heart disease and those with protein loss due to an inflamed or abnormal mucosal surface. The diagnosis is confirmed by increased fecal concentrations of alpha-1-antitrypsin. After PLE is diagnosed, the underlying cause should be identified by stool cultures, serologic evaluation, cardiac screening, or radiographic imaging. Treatment of PLE consists of nutrition state maintenance by using a high protein diet with supplement of fat-soluble vitamins. In patients with lymphangiectasia, a low fat with medium chain triglycerides (MCT) diet should be prescribed. Besides dietary adjustments, appropriate treatment for the underlying etiology is necessary and supportive care to avoid complications of edema. PLE is a rare complication of various diseases, mostly gastrointestinal or cardiac conditions that result into loss of proteins in the gastrointestinal tract. Prognosis depends upon the severity and treatment options of the underlying disease.

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Protein-Losing Enteropathy Detected on Tc-99m HSA and Tc-99m MDP Scintigraphy

Cited by 18 publications

References 6 publications

A Gentleman with an Unusual Cause of Hypoalbuminemia

A Gentleman with an Unusual Cause of Hypoalbuminemia

Protein-Losing Enteropathy Associated with Henoch-Schönlein Purpura

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