Exudative Enteropathy

Abstract

A number of cases of severe hypoproteinemia of obscure origin have been described in recent years. It had been demonstrated that in such patients the fabrication of serum proteins is proceeding at an increased rate but the route through which the serum proteins were being lost could not be located. The findings in the present study implicate the gastrointestinal tract as the route of loss of proteins from the plasma in this group of disorders, referred to as examples of hypercatabolic hypoproteinemia. In view of the discovery that the protein may be lost through the gastrointestinal tract, the term exudative enteropathy is suggested for this group of disorders. The loss of plasma protein through the gastrointestinal tract was demonstrated by the use of a labelled macromolecule (I-labelled polyvinylpyrrolidone). When this material is injected intravenously, if it leaks through the mucosa of the gastrointestinal tract, it is excreted in the feces where it can be estimated readily. The majority of such patients have no complaints referrable to the gastrointestinal tract or have had only minor symptoms that ordinarily would not be considered significant. The cases reported resemble those described by Ulstrom et al. in children (Am. J. Dis. Child., 92:219, 1956). Application of this technique will undoubtedly elucidate many of the cases of idiopathic hypoproteinemia in childhood.