Exudative enteropathy

Exudative enteropathy: causes, symptoms, diagnosis and treatment

Exudative enteropathy is a heterogeneous group of diseases and pathological conditions characterized by increased loss of plasma proteins through the gastrointestinal tract with symptoms of impaired absorption, hypoproteinemia, edema and delayed physical development. This pathology can be either hereditary or acquired due to various chronic gastrointestinal diseases.

Etiology and pathogenesis

Primary exudative enteropathy is a hereditary disease caused by mutations in genes responsible for the development of lymphatic vessels. The secondary form occurs as a result of various chronic diseases of the gastrointestinal tract, such as ulcerative colitis, Crohn's disease, celiac disease and others.

In most patients, lymphangiectasia is found in a limited area or throughout the entire intestine. Lymphatic vessels become more permeable, which leads to increased loss of proteins through the intestinal wall.

Clinical picture

Exudative enteropathy most often develops acutely after the first year of life, but can have a transient and chronic course. The clinical picture consists of the following symptoms: edema, delayed physical development, diarrhea, weight loss. Swelling may be small or widespread in the form of anasarca. In some cases, hypocalcemic convulsions and extreme dystrophy are observed.

The loss of plasma protein, which also contains all classes of immunoglobulins, sharply reduces the overall resistance of children to infections and causes a protracted course of infectious diseases.

Diagnostics

To make a diagnosis of exudative enteropathy, medical history, clinical symptoms, results of an X-ray examination of the intestine and a biopsy of the small intestinal mucosa are used. Differential diagnosis is made with nephrotic syndrome. A distinctive feature in this case is the discrepancy between hypoproteinemia and the protein content in the urine. The presence of blood plasma protein in the stool speaks in favor of exudative enteropathy.

Treatment

It is advisable to begin treatment of exudative enteropathy as early as possible. A diet high in protein and fat, as well as limited salt and liquid, is indicated. To compensate for protein loss, protein preparations and amino acids are prescribed. Diuretics can be used to relieve swelling.

It is also important to treat the underlying disease that led to the development of exudative enteropathy. If necessary, surgical treatment is performed, for example, bowel resection.

Forecast

The prognosis depends on how quickly and correctly treatment was started. Timely treatment can significantly improve the prognosis and prevent the development of serious complications. However, in some cases, exudative enteropathy can lead to chronic edema, digestive disorders and delayed physical development.