Protein‐losing gastroenteropathy with severe hypoalbuminemia associated with Sjögren’s syndrome: A case report and review of the literature

Abstract

A 30‐year‐old man with severe hypoalbuminemia (serum albumin: 0.9 g/dL) was admitted with severe bilateral leg edema and unilateral pleural effusion. Serum anti‐SS‐A and SS‐B antibody levels were abnormally elevated, and his symptoms fulfilled the diagnostic criteria for Sjögren's syndrome. Technetium‐99m albumin scintigraphy revealed protein leakage from a large area of the small intestine. Immunohistochemistry revealed perivascular deposition of C1q, C3d, and immunoglobulin G in the duodenal mucosa. The patient was diagnosed with protein‐losing gastroenteropathy associated with Sjögren's syndrome. Within 2 months of treatment with oral prednisolone and mycophenolate mofetil, the clinical symptoms of hypoalbuminemia and Sjögren's syndrome disappeared completely.

Decreased Protein Levels and Vitamin B12 Plasma Concentration in Primary Sjögren Syndrome are Associated with Peripheral Neuropathy: A Case-Control Study

“…Sene, et al justified this particular finding with the significant increased frequency of Non Hodgkin lymphoma in Sjögren patients with peripheral nervous system involvement [25]. Dysproteinemia can manifest in a variety of ways, with high total protein levels due to hypergammaglobulinemia, or low albumin levels, which can be secondary to a protein-losing gastroenteropathy, renal or liver involvement [26,27].…”

Case Studies of Acute Cholecystitis Complicating Biliary Metal Stent-in-Stent after ERCP

“…Intestinal loss of lymphatic fluid can be caused by impaired lymph drainage due to primary intestinal lymphatic disorders or secondary causes [3]. Increased mucosal permeability may be the result of several non-erosive gastrointestinal diseases like celiac disease, rheumatic diseases, and amyloidosis [4]. Inflammatory exudation from mucosal erosions and ulcerations can occur in erosive gastrointestinal disorders like inflammatory bowel disease (IBD), gastrointestinal malignancies, and colitis due to Clostridioides difficile infection (CDI) [5].…”