No abstract available.
Anemia, Iron-Deficiency* ; Hypoproteinemia* ; Iron*

Of the various causes of malabsorption, to our knowledge, blind loop syndrome has been reported in Korea only rarely. Here, we report the case of a 63-year-old woman with hepatitis C virus-associated liver cirrhosis. The patient complained of abdominal distension and had an abnormal serum biochemistry caused by blind loop syndrome related to childhood abdominal surgery. Her laboratory findings showed an iron deficiency anemia, hypocholesterolemia, hypoproteinemia and hypoalbuminemia, and were confounded with those of liver cirrhosis. She underwent resection of the blind loop segment of the small intestine, after which her abdominal symptoms and abnormal laboratory findings improved, although they did not completely normalize due to her liver cirrhosis.
Anemia, Iron-Deficiency ; Biochemistry ; Blind Loop Syndrome ; Female ; Hepatitis C ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Intestine, Small ; Korea ; Liver ; Liver Cirrhosis ; Middle Aged

Pseudomembranous colitis can be induced by the therapeutic or prophylactic use of antibiotics, and antibiotics- induced colitis has become a severe clinical problem. Protein?loosing enteropathy is associated with an abnormal, excessive loss of serum proteins into the gastrointestinal tract, and this leads to hypoproteinemia, including hypoalbuminemia, edema and diarrhea. We present here a case of protein?loosing enteropathy that was induced by pseudomembranous colitis, and this was induced by the use of antibiotics. Patients with chronic renal disease and peritonitis show hypoalbuminemia and edema. We experienced a patient who displayed edema, hypoalbuminemia, diarrhea and a fever for several days after the use for antibiotics for treating his peritonitis. We made the diagnosis of protein-loosing enteropathy complicated by psuedomembranous colitis. In a patient with peritonitis, uncontrolled edema and diarrhea, and the patient's hypoalbuminemia is continued, we must consider the possibility that the patient has protein-loosing enteropathy, and we should examine the total protein level and the alpha 1-antitrypsin clearance.
alpha 1-Antitrypsin ; Anti-Bacterial Agents ; Blood Proteins ; Colitis ; Diarrhea ; Edema ; Enterocolitis, Pseudomembranous ; Fever ; Gastrointestinal Tract ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Peritonitis ; Renal Insufficiency, Chronic

Primary intestinal lymphangiectasia is a rare congenital cause of protein losing enteropathy that is characterized by chronic diarrhea, generalized edema, ascites, hypoproteinemia, hypoalbuminemia, and lymphopenia. We encountered an 18-year-old woman who suffered from longstanding diarrhea and progressive leg edema. The laboratory findings showed the typical features of this disorder. The presence of enteric protein loss was documented with the 24 hour fecal clearance of alpha(1)-antitrypsin and (99m)Tc human serum albumin scintigraphy. A duodenoscopy and biopsy showed scattered white spots and markedly dilated lymphatics in the tips of the villi, respectively. The patient's clinical symptoms improved after placing her on a high protein and low fat diet with medium chain triglyceride supplements.
Adolescent ; Ascites ; Biopsy ; Dental Caries ; Diarrhea ; Diet ; Duodenoscopy ; Edema ; Female ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Leg ; Lymphopenia ; Protein-Losing Enteropathies* ; Radionuclide Imaging ; Serum Albumin ; Triglycerides

BACKGROUND/AIM: It is not easy to differentiate Salmonella from acute viral hepatitis (AVH), especially in the case of jaundice. Therefore we analyzed the differences between Salmonella hepatitis and AVH-B. METHOD: Our study was performed retrospectively on 11 patients with acute hepatitis who had positive blood culture for Salmonella typhi and 11 patients with AVH-B as controls. RESULT: The greater proportion of patients with Salmonella experienced fever, headache, diarrhea, relative bradycardia and hepatomegaly in contrast to the patients with AVH-B (p<0.05). But jaundice was detected more frequently in patients with AVH-B. The laboratory findings that were noted more in Salmonella patients than AVH-B patients were: left shift of leukocyte, anemia, thrombocytopenia, hypoproteinemia, hypoalbuminemia, lower peak levels of aminotransferase and total bilirubin, a trend toward a higher peak level of serum LDH and lower ratio of ALT/LDH expressed as a multiple of the upper limit of normal level on admission (p<0.05). Acute cholecystitis was complicated in 2 patients with Salmonella. One was resolved by cholecystostomy and the other had surgical intervention. The other 9 patients recovered with appropriate administration of antibiotics. CONCLUSION: The clues that raise the possibility of Salmonella over AVH-B include: high fever, headache, diarrhea, relative bradycardia, hepatmegaly, left shift of leukocyte, anemia, thrombocytopenia, hypoproteinemia, hypoalbuminemia, a markedly elevated serum level of LDH and lower ALT/LDH ratio (less than 4) on admission. Of these, ALT/LDH ratio is the best discriminator between Salmonella and AVH-B. Early diagnosis and appropriate administration of antibiotics are necessary for the successful treatment of Salmonella.
Anemia ; Anti-Bacterial Agents ; Bilirubin ; Bradycardia ; Cholecystitis, Acute ; Cholecystostomy ; Diarrhea ; Early Diagnosis ; Fever ; Headache ; Hepatitis* ; Hepatomegaly ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Jaundice ; Leukocytes ; Retrospective Studies ; Salmonella typhi* ; Salmonella* ; Thrombocytopenia

BACKGROUND: Although hypoalbuminemia is common in patients with tsutsugamushi disease, acute rickettsial infectious disease, its impact on the severity of disease is not reported. Therefore, we studied the role of hypoalbumiemia as a marker of the severity of disease in patients with tsutsugamushi disease. METHODS: We retrospectively reviewed clinical data of 95 patients with tsutsugamushi disease who were admitted between January 1994 and December 1999 at Uijongbu St. Mary's hospital. We compared clinical and laboratory findings, complications, and mortality between hypoalbuminemic group (serum albumin < 3.0 g/dL) and control (serum albumin > or = 3.0 g/dL). RESULTS: Of the total 95 patients, 50 patients (52.6%) had hypoalbuminemia. In hypoalbuminemic group, the incidence of hypotension was higher (20.0% vs 2.2%, p=0.006) and the duration of admission was longer (12.0+/-4.5 vs 8.8+/-2.7 days, p<0.001), compared to control. The degree of thrombocytopenia in hypoalbuminemic group was severer than that in control (84,000+/-46,000 vs 138,000+/-75,000/mm3, p<0.001). Hypoalbuminemic group showed higher incidence of interstitial pneumonia (64.0 vs 13.3%, p<0.001), hypoxia (40.0 vs 6.6%, p<0.001), metabolic acidosis (12.0 vs 0%, p=0.018), and acute renal failure (18.0 vs 4,4%, p=0.038), compared to control. Four patients who had hypoalbuminemia died due to septic shock and multiorgan failure. CONCLUSION: This study shows that hypoalbuminemia could be used as a marker of the severity of disease in patients with tsutsugamushi disease.
Acidosis ; Acute Kidney Injury ; Anoxia ; Communicable Diseases ; Humans ; Hypoalbuminemia* ; Hypoproteinemia ; Hypotension ; Incidence ; Lung Diseases, Interstitial ; Mortality ; Retrospective Studies ; Rickettsia ; Scrub Typhus* ; Shock, Septic ; Thrombocytopenia

Intestinal lymphangiectasia (IL) is a rare disorder, characterized by dilatation of intestinal lymphatics and leakage from ruptured lacteals to the intestinal lumen. Primary IL may be due to a congenital malformation of the lymphatic system, whereas secondary IL is caused by decreased lymph flow from thoracic ductsdue to elevated left subclavian vein pressure as a result of a preceding inflammatory or neoplastic disease. IL can present as protein-losing enteropathy with clinical manifestations of hypoproteinemia, hypoalbuminemia, edema, ascites, or pleural effusions. In very rare cases, it can present as severe intestinal bleeding. We experienced a 48-year-old woman presenting with recurring hematochezia and melena. She was diagnosed bydouble balloon enteroscopy, and surgical resection was needed to stop bleeding. In conclusion, IL can present clinically as painless chronic blood loss. If IL is locally distributed, surgical resection may be needed to control bleeding and to exclude other underlying causes in some patients.
Ascites ; Dilatation ; Double-Balloon Enteroscopy ; Edema ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Lymphatic System ; Melena ; Middle Aged ; Pleural Effusion ; Protein-Losing Enteropathies ; Subclavian Vein

OBJECTIVE: Anemia had been reported to be one of the common complications in the spinal cord injured patients. The purposes of this study were to investigate the incidence of anemia, its relating factors and efficacy of rehabilitation therapy in the acute spinal cord injured patients. METHOD: A retrospective study was performed in the 103 acute spinal cord injured patients. We monitored serum hemoglobin, serum hematocrit, serum albumin and protein and change of the weight in the acute spinal cord injured patients at our rehabilitation department. RESULTS: The incidence of anemia was 62.1% (64/103). According to the level of injury, the incidence of anemia was 65.2% in cervical cord injury, 62.5% in thoracic cord injury and 46.2% in lumbar cord injury. The incidence of anemia was not different significantly by the severity of injury. The relating factors of anemia were urinary tract infection, pressure sore, acute bleeding, pneumonia, hypoalbuminemia, hypoproteinemia. Among these, hypoproteinemia was statistically related to anemia. The efficacy of functional independence measure (FIM) was significantly lower in the anemic group. CONCLUSION: Therefore we should concern about the prevention and treatment of anemia in the spinal cord injured patients.
Anemia* ; Hematocrit ; Hemorrhage ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Incidence ; Pneumonia ; Pressure Ulcer ; Rehabilitation ; Retrospective Studies ; Serum Albumin ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Tract Infections

Menetrier's disease in childhood is a rare form of gastropathy characterized by hypoalbuminemia, endoscopic and/or radiologic findings of hypertrophic gastric folds, and histologic findings of foveolar hyperplasia in the stomach. It tends to have a self-limited course compared to the chronic and complicated course in adult Menetrier's disease. A 7-year-old boy was referred to Incheon St. Mary's Hospital for facial edema. Physical examination on admission showed periorbital swelling, pitting edema in both legs, and epigastric tenderness. Laboratory tests on admission indicated hypoproteinemia (3.0 g/dL) with hypoalbuminemia (2.1 g/dL) and hypogammaglobulinemia. Urinalysis showed no abnormalities. The test results for anti-cytomegalovirus immunoglobulin M and cytomegalovirus PCR were negative. Stool Helicobacter pylori antigen was positive and fecal alpha1-antitrypsin clearance was 40.1 mL/day, consistent with protein-losing gastroenteropathy. Gastroduodenoscopy showed hypertrophic edematous gastric folds, erythema, and superficial erosion in the body of the stomach. The duodenum was normal. Histologic findings showed foveolar hyperplasia. His symptoms improved with conservative treatment including proton pump inhibitor from day 9 of hospitalization and resolved completely. Here we reported a case of pediatric protein-losing hypertrophic gastropathy associated with Helicobacter pylori infection.
Adult ; Agammaglobulinemia ; Child ; Cytomegalovirus ; Duodenum ; Edema ; Erythema ; Gastritis, Hypertrophic* ; Helicobacter pylori* ; Hospitalization ; Humans ; Hyperplasia ; Hypoalbuminemia ; Hypoproteinemia ; Immunoglobulin M ; Incheon ; Leg ; Male ; Physical Examination ; Polymerase Chain Reaction ; Proton Pumps ; Stomach ; Urinalysis

Menetrier's disease is a rare form of acquired gastropathy characterized by giant rugal folds in the stomach and protein-losing gastropathy. Children with Menetrier's disease tend to follow a benign self-limited course with symptoms typically completely resolving within 2 to 10 weeks in contrast to the chronic course in adults. A 9-year-old girl presented with a history of gradually worsening abdominal distension, increasing body weight, and abdominal pain for 2 weeks. Physical examination on admission indicated periorbital swelling, pitting edema in both the legs, and abdominal distension with mild diffuse tenderness and shifting dullness. Laboratory tests on admission showed hypoalbuminemia, hypoproteinemia, and peripheral eosinophilia. The test result for anticytomegalovirus immunoglobulin M was negative. Increased fecal alpha 1 anti-trypsin excretion was observed. Radiological findings showed massive ascites and pleural effusion in both the lungs. On gastroscopy, large gastric folds, erythema, erosion, and exudation were noted in the body and fundus of the stomach. Microscopic findings showed infiltration of eosinophils and neutrophils in the gastric mucosa. Her symptoms improved with conservative treatment from day 7 of hospitalization and resolved completely.
Abdominal Pain ; Adult ; Ascites ; Body Weight ; Child ; Cytomegalovirus ; Edema ; Eosinophilia ; Eosinophils ; Erythema ; Gastric Mucosa ; Gastritis, Hypertrophic ; Gastroscopy ; Hospitalization ; Humans ; Hypoalbuminemia ; Hypoproteinemia ; Immunoglobulin M ; Leg ; Lung ; Neutrophils ; Physical Examination ; Pleural Effusion ; Protein-Losing Enteropathies ; Stomach