Endoscopic and Imaging Findings in Protein-losing Enteropathy

Takenaka, Hiroyuki; Ohmiya, Naoki; Hirooka, Yoshiki; Nakamura, Masanao; Ohno, Eizaburo; Miyahara, Ryoji; Kawashima, Hiroki; Itoh, Akihiro; Watanabe, Osamu; Ando, Takafumi; Goto, Hidemi

doi:10.1097/mcg.0b013e31823832ac

Cited by 29 publications

(16 citation statements)

References 19 publications

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“…Arguably, the presence of small intestine varices in the PHE group is similar to that reported previously [10,11]. Since red spots and small intestine wall edema are major components of congestive enteropathy, these subtle findings can be underreported [15].…”

supporting

confidence: 87%

Portal Hypertensive Enteropathy, Occult Bleeding, and Capsule Endoscopy: Where Do We Go from Here?

Dabos

Koulaouzidis

2014

Dig Dis Sci

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supporting

confidence: 87%

Portal Hypertensive Enteropathy, Occult Bleeding, and Capsule Endoscopy: Where Do We Go from Here?

Dabos

Koulaouzidis

2014

Dig Dis Sci

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“…PLE was confirmed by fecal α 1 -antitrypsin (α 1 -AT) clearance and/or technetium-99m human serum albumin (HSA) scintigraphy, accompanied by hypoproteinemia (serum total protein value <6.0 g/dl or serum albumin value <3.0 g/dl). Fecal α 1 -AT was measured as previously described [10]. Values indicative of PLE were α 1 -AT clearance >13 ml/day.…”

Section: Methodsmentioning

confidence: 99%

“…Values indicative of PLE were α 1 -AT clearance >13 ml/day. HSA scintigraphy was performed as previously described [10]. As overt gastrointestinal bleeding can show false positivity at both of these examinations, patients with overt bleeding were excluded.…”

Section: Methodsmentioning

confidence: 99%

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Classification of Intestinal Lymphangiectasia with Protein-Losing Enteropathy: White Villi Type and Non-White Villi Type

Ohmiya

Nakamura²,

Yamamura³

et al. 2014

Digestion

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Background/Aims: We classified intestinal lymphangiectasia (IL) into two categories, the white and non-white villi types, and evaluated their clinical characteristics and therapeutic responses. Methods: Of the 988 patients who underwent double-balloon enteroscopy, 14 consecutive patients (7 men and 7 women, median age at onset 34 years) were enrolled with immunohistochemically confirmed IL with protein-losing enteropathy. Results: Enteroscopically the white villi type (n = 8) showed white plaques and white-tipped villi were scattered in the small bowel, while non-white villi type (n = 6) showed that apparently normal but under more detailed observation, low and round villi with a normal color were diffused. The serum albumin levels and fecal E₁-antitrypsin clearance before treatment were significantly worse in the non-white villi type (p = 0.017 and 0.039, respectively), whereas the serum immunoglobulin A and M levels were significantly lower in the white villi type (p = 0.010 and 0.046, respectively). At gastroscopy, a non-cirrhotic snakeskin appearance was significantly observed in the non-white villi type (p = 0.015). The corticosteroid response was better in the non-white villi type (p = 0.015). Conclusion: Two distinct subgroups were found in IL. This classification was useful in pathophysiological clustering and in predicting the therapeutic response. i 2014 S. Karger AG, Basel

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“…In patients with a small intestinal disorder, the small intestinal mucosa potentially loses the ability to perform certain functions (10). The aims of this study were to investigate the mRNA and protein expressions of biomarkers related to nutrition in the GI mucosa and assess the relationships between small intestinal disease and nutrition.…”

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confidence: 99%

Evaluation of the mRNA and Protein Expressions of Nutritional Biomarkers in the Gastrointestinal Mucosa of Patients with Small Intestinal Disorders

et al. 2016

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Objective The objectives of this study were to investigate the mRNA and protein expression of biomarkers related to absorption in the small intestinal mucosa of humans and determine the relationships between small intestinal diseases and nutrition. Methods The study subjects consisted of patients scheduled to undergo double-balloon endoscopy (DBE) or total colonoscopy for suspected gastrointestinal disorder in a clinical practice. Biopsies were taken from apparently normal mucosa in the visible areas of 6 parts of the intestines from the duodenum to the colon. The mRNA expression of specific biomarkers (SGLT1, SGLT5, GIP, GLP, LAT1, LAT2, and NPC1L1) in the mucosa was compared among three patient groups: Inflammation, Tumor, and Control. Results Sixty-six patients participated in this study. Both routes of DBE were performed in 20 patients, in whom biopsy samples were obtained from the mucosa for all sections. There were no remarkable differences in the mRNA expression levels among the 3 groups. However, SGLT1, GIP, GLP, and NPC1L1 exhibited specific distribution patterns. The expression levels of GIP and NPC1L1 were highest in the upper jejunum, but were extremely low in the terminal ileum and colon. A comparison of the mRNA expression profile in each intestinal section revealed that the SGLT1 mRNA expression in the Tumor group and the GIP mRNA expression in the Inflammation group were significantly higher than the corresponding levels in the Control group in the upper jejunum. Conclusion The gastrointestinal mucosa of patients with small bowel diseases can maintain proper nutrient absorption, except in the upper jejunum.

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Endoscopic and Imaging Findings in Protein-losing Enteropathy

Abstract: DBE with pathologic findings of biopsy specimens was useful for the differential diagnosis of PLE. Noninvasive VCE might be preferable and useful for screening and follow up of PLE without stricture. Prognosis of a subgroup of PLE was poor regardless of treatment.

Cited by 29 publications

References 19 publications

Portal Hypertensive Enteropathy, Occult Bleeding, and Capsule Endoscopy: Where Do We Go from Here?

Portal Hypertensive Enteropathy, Occult Bleeding, and Capsule Endoscopy: Where Do We Go from Here?

Classification of Intestinal Lymphangiectasia with Protein-Losing Enteropathy: White Villi Type and Non-White Villi Type

Evaluation of the mRNA and Protein Expressions of Nutritional Biomarkers in the Gastrointestinal Mucosa of Patients with Small Intestinal Disorders

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