Abstract
The patient was a 59-year-old male who came to the hospital with diarrhea. Polyposis of the stomach and colon, cutaneous pigmentation, alopecia, deformity of finger nails and severe hypoproteinemia were observed. When local fibrinolysis in biopsy tissue collected under endoscopy was measured by the fibrin plate method, high concentration of fi-brinolytic activity was observed in both the gastric and colonic mucosa. In addition to nutritional supplements, 600mg/day of camostat mesilate orally and 500mg/day of tranex-amic acid intravenously were administered concomitantly. About 3 months later, the subjective symptoms and hypoproteinemia had improved, and the gastric and colonic polyposis disappeared after 4-6 months. The fibrinolytic activity decreased as the clinical symptoms improved, and changed in parallel with the clinical course. In cases of this syndrome reported in Japan up to now, antiplasmin therapy was performed on 12 cases. Eight of them were improved or cured, and the treatment was ineffective in four cases. There have been almost no studies concerning the fibrinolytic activity of the gastrointestinal mucosa, and this case provided many suggestions concern-ing the mechanism of protein loss into the digestive tract and the treatment of this syndrome.
