Recurrent hemolytic uremic syndrome associated with intestinal lymphangiectasia.

Recurrent hemolytic uremic syndrome associated with intestinal lymphangiectasia.
J Nephrol. 2007 Mar-Apr
Kalman S,
Bakkaloglu S,
Dalgic B,
Ozkaya O,
Soylemezoglu O,
Buyan N.

Department of Pediatric Nephrology, Gazi University, Besevler, Ankara - Turkey.

A 17-year-old boy was admitted to the hospital twice in a year for 2 episodes of hemolytic uremic syndrome (HUS). During these 2 HUS episodes he had diarrhea, decreased serum complement, decreased total protein and decreased serum albumin concentrations. We suggest that protein-losing enteropathy and hypocomplementemia due to intestinal lymphangiectasia is may be a rare cause of atypical HUS.

PMID: 17514630 [PubMed - in process]

A primary intestinal lymphangiectasia patient diagnosed by capsule endoscopy and confirmed at surgery: A case report.

A primary intestinal lymphangiectasia patient diagnosed by capsule endoscopy and confirmed at surgery: A case report.
World J Gastroenterol. 2007 Apr

Fang YH,
Zhang BL,
Wu JG,
Chen CX.
Department of gastroenterlogy, The First Affiliated Hospital of College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. chcx@zj139.com.

Intestinal lymphangiectasia (IL) is a rare disease characterized by dilated lymphatic vessles in the intestinal wall and small bowel mesentery which induce loss of protein and lymphocytes into bowel lumen. Because it most often occurs in the intestine and cannot be detected by upper gastroendoscopy or colonoscopy, and the value of common image examinations such as X-ray and computerized tomography (CT) are limited, the diagnosis of IL is difficult, usually needing the help of surgery.

Capsule endoscopy is useful in diagnosing intestinal diseases, such as IL. We here report a case of IL in a female patient who was admitted for the complaint of recurrent edema accompanied with diarrhea and abdominal pain over the last twenty years, and aggravated ten days ago. She was diagnosed by M2A capsule endoscopy as a primary IL and confirmed by surgical and pathological examination.

World Journal of Gastroenterology

A case of recurrent gastrointestinal bleeding and protein-losing gastroenteropathy.

A case of recurrent gastrointestinal bleeding and protein-losing gastroenteropathy.

Nat Clin Pract Gastroenterol Hepatol. 2007 May
Herfarth H,
Hofstadter F,
Feuerbach S,
Jurgen Schlitt H,
Scholmerich J,
Rogler G.
Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC 27599, USA. hherf@med.unc.edu

BACKGROUND: A 40-year-old male with pentalogy of Fallot (a congenital heart defect with five anatomical components) presented with recurrent gastrointestinal bleeding. He had recently recovered from a heart operation, which was performed to reconstruct the right ventricular outflow tract.

INVESTIGATIONS: Laboratory tests and absorption tests, esophagogastroduodenoscopy, capsule endoscopy, human serum albumin scintigraphy, lymphoscintigraphy, CT and abdominal lymph-node histology.

DIAGNOSIS: Intestinal lymphangiectasia with concurrent protein-losing gastroenteropathy and recurrent gastrointestinal bleeding.

MANAGEMENT: Despite a low-fat diet and surgical suturing of multiple small-bowel ulcerations the gastrointestinal bleeding continued. Serum albumin levels remained very low and severe lymphedema occurred. Unfortunately, the patient developed severe sepsis and died of multiple organ failure.

PMID: 17476211 [PubMed - in process]

Intestinal lymphangiectasia secondary to radiotherapy and chemotherapy.

This is an older article going back to 1987. I found it interesting however as it is a report of secondary intestinal lymphangiectasia from an unexpected souce, cancer treatment.

The article:

Intestinal lymphangiectasia secondary to radiotherapy and chemotherapy.

Dig Dis Sci. 1987 Aug

Rao SS,
Dundas S,
Holdsworth CD.

We report a case of intestinal lymphangiectasia secondary to radiotherapy and chemotherapy. The patient also had small bowel bacterial overgrowth and pancreatic insufficiency. Lymphatic ectasia as a histological feature has been described previously in association with postradiotherapy malabsorption, but radiation-induced lymphangiectasia producing clinical manifestations has hitherto not been reported. Replacement of dietary long-chain fats with medium-chain triglycerides, pancreatic enzyme supplements, and a short course of oxytetracycline, resulted in dramatic clinical improvement.

The possibility of intestinal lymphangiectasia should be borne in mind in patients with postradiotherapy malabsorption. A low serum albumin and lymphocyte count should draw attention to this possibility.

PMID: 3608736 [PubMed - indexed for MEDLINE]