Unusual protein-losing enteropathies in children.

Abstract

Gastrointestinal protein loss in children has been described in a rapidly growing list of disease states. The site and extent of the protein loss can be studied by utilizing immunologic and isotopically labeled protein methods. The isotopes used are iodinated po1yvinylpyyrrolidone (131PVPI), iodinated serum proteins, and chromium-labeled proteins. These technics have shown that the loss of serum proteins into the intestina11umen plays an important part in their normal degradation. When serum proteins are lost into the gastrointestinal tract, whether in normal or abnormally large amounts, they are rapidly catabolized into their constituent amino acids. These amino acids are then reabsorbed and made available for protein resynthesis by the liver. The maximal protein synthesis ability of the liver is approximately double its normal rate. In many of the severe protein-losing enteropathies the rate of intestinal protein loss greatly exceeds the ability of the liver to respond, and hypoproteinemia, edema, and a...