Protein-losing gastroenteropathy in a patient with concomitant systemic lupus erythematosus and Sjögren’s syndrome

  • Mizuna Eguchi
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Nozomi Iwanaga
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Kosuke Sakai
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Tohru Michitsuji
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Yoshika Tsuji
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Chieko Kawahara
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Hitomi Kobayashi
    Department of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Yoshiro Horai
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Takahiro Mori
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Yasumori Izumi
    Department of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Masahiro Ito
    Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;
  • Atsushi Kawakami
    Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

説明

We report a female in her twenties who developed generalized edema. She was diagnosed as systemic lupus erythematous (SLE) and Sjögren's syndrome (SS) based on her physical manifestations and positive findings for antinuclear antibody and anti-SS-A/SS-B-antibody. Although she manifested hypoproteinemia, a possibility of lupus nephritis was denied due to a lack of significant abnormality in kidney function tests and urinalysis. The nature of hypoproteinemia and related symptoms was identified as protein losing gastroenteropathy (PLGE) based on α 1-antitrypsin clearance and histopathology findings. Physicians should be aware that PLGE may develop as an underlying cause of edema in SLE and SS.

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