EXUDATIVE ENTEROPATHY

Abstract

Loss of plasma protein into the gastrointestinal tract in the absence of actual bleeding has recently been demonstrated as a cause of "idiopathic hypoproteinemia." The euphonious name, "exudative enteropathy," has been used by Gordon to describe a group of nine patients, including a 2-year-old boy, whose common finding was hypoproteinemia due to loss of plasma protein into the gastrointestinal tract. A concomitant report by Schwartz and Jarnum confirms the association of these events in four additional patients. Although the first such patient reported had quantities of plasma protein present in the gastric juice sufficient to allow their demonstration by electrophoresis, the rapid digestion of the proteins by the enzymes normally present in the gastrointestinal tract has required the use of less direct methods in most of the subsequent cases. Using a preparation of I131-labelled polyvinyl pyrrolidone (a plasma substitute with average molecular weight the same as serum albumin) Gordon has devised a test that avoids the problems created by the gastrointestinal digestion of protein.