An exotic cause of exudative enteropathy

Abstract

Patient: Male, 50Final Diagnosis: Exudative enteropathySymptoms: Abdominal pain • diarrhea • fever • hyponatremia • lymphadenopathy • weight lossMedication: —Clinical Procedure: —Specialty: —Objective:Unusual clinical courseBackground:Protein-losing enteropathy is a rare cause of hypoproteinemia. Erosive and non-erosive gastrointestinal diseases as well as vascular disorders that result in increased central venous pressure or mesenteric lymphatic obstruction may result in protein loss via the gastrointestinal tract.Case Report:We present the case of a 50-year-old man with protein-losing enteropathy, who had profuse diarrhea, abdominal pain, lymphadenopathy, fever, and a weight loss of 10 kg in the preceding 2 months. Extensive work-up revealed infection with Giardia lamblia. We review clinical signs and symptoms, laboratory findings, and imaging studies, and discuss potential pitfalls in establishing the diagnosis.Conclusions:To the best of our knowledge, this represents one of the few published cases of intestinal giardiasis as a cause of protein-losing enteropathy in an immunocompetent adult. The diagnosis of lambliasis should be based on a combination of stool cultures and serum serology, and in cases of high clinical suspicion, an endoscopy and biopsy of the upper GI tract is recommended.

Genotyping and Phylogenetic Analysis of Giardia duodenalis Isolates from Turkish Children

“…The main route of infection is fecal-oral transmission via contaminated food and water. The infection has a broad spectrum, ranging from asymptomatic infections to chronic diarrhea [ 4 ]. G. duodenalis is an important intestinal protozoan in Turkey, with infection rates of children ranging from 17.3% to 33.3% [ 5 ].…”

“…Different symptoms are linked to different assemblages in different populations [ 6 ] Therefore, several molecular studies have divided this into various assemblages or genotypes, which not only demonstrate host specificity patterns but also differ in a range of other phenotypic aspects. As a result, several loci have been described for determining these assemblages: triose phosphate isomerase ( tpi ), β-giardin , small subunit ribosomal RNA ( SSU rRNA ), glutamate dehydrogenase ( gdh ), and elongation factor genes [ 4 ]. Assemblages A and B are zoonotic, infecting humans and animals and the prevalence varies in different geographic areas [ 7 ].…”