Exudative enteropathy

Exudative enteropathy is a heterogeneous group of diseases and pathological conditions characterized by increased loss of plasma proteins through the gastrointestinal tract with the phenomena of impaired absorption, hypoproteinemia, edema, and delay in physical development.

Etiology, pathogenesis. Distinguish between primary (hereditary) and secondary (acquired) exudative enteropathy (with various chronic gastrointestinal diseases). In most patients, lymphangiectasia is detected in a restricted area or throughout the intestine.

Clinical picture. The disease often develops sharply after a year, but transient and chronic course is not excluded. The clinic consists of the following symptoms: swelling, delayed physical development, diarrhea, weight loss. Edema can be small or common in the form of anasarca. In a small number of cases, hypocalcemic convulsions and an extreme degree of dystrophy are observed. The loss of plasma protein, which also contains all classes of immunoglobulins, dramatically reduces the overall resistance of children to infections and causes a protracted course of infectious diseases.

The diagnosis is based on history and clinical symptoms.

Differential diagnosis is carried out with nephrotic syndrome. A distinctive feature in this case is the incompatibility of hypoproteinemia with the quantitative content of protein in the urine. The presence of protein in feces, especially in large amounts, speaks in favor of exudative enteropathy.

It is advisable to begin treatment as early as possible. Parenterally injected protein preparations (albumin, plasma, etc.), restrict fats, use unsaturated fatty acids (vegetable oils); Recommended vitamins, enzymes, anabolic hormones, etc. Specific therapy is not developed.

The prognosis for primary exudative enteropathy is serious