Protein-losing gastropathy associated with autoimmune disease: successful treatment with prednisolone

J Gastroenterol. 2002;37(3):204-9. doi: 10.1007/s005350200022.

Abstract

We report a patient with protein-losing gastropathy probably associated with autoimmune disease, in whom prednisolone treatment was highly effective. A 45-year-old woman was admitted to our hospital with edema of the face and lower extremities. Blood examination revealed hypoproteinemia, hypoalbuminemia, and hypercholesteremia. Renal biopsy revealed no definite findings of lupus nephritis, including vasculitis. A diagnosis of protein-losing gastropathy was made on the basis of increased alpha1-antitrypsin clearance and 99mTc-labeled human serum albumin scintigram showing abnormal radioactivity in the stomach. Endoscopic gastric biopsies revealed nonspecific inflammation, but marked intramural edema. Based on a slight elevation of antinuclear antibody level, autoimmune disease was suspected to be involved in this patient. Administration of prednisolone, as a diagnostic therapy, alleviated the hypoproteinemia, hypoalbuminemia, and hypercholesteremia. These findings suggest that an autoimmune mechanism could have been involved in this case of protein-losing gastropathy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antibodies, Antinuclear / analysis
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / diagnosis
  • Biopsy
  • Edema / drug therapy
  • Edema / etiology
  • Female
  • Humans
  • Hypoproteinemia / etiology
  • Leg
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / drug therapy*
  • Middle Aged
  • Prednisolone / therapeutic use*
  • Protein-Losing Enteropathies / complications
  • Protein-Losing Enteropathies / diagnosis
  • Protein-Losing Enteropathies / drug therapy*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Antinuclear
  • Prednisolone