A case of Sjögren's syndrome associated with protein-losing enteropathy

Abstract

We report a 47-year-old woman with Sjögren's syndrome associated with protein-losing enteropathy. She also complicated with chronic thyroiditis. She was admitted to our hospital because of anasarca. Serum albumin was 1.6g/dl and total serum cholesterol 252mg/dl. Renal and hepatic function tests were normal. Quantitative urinary proteins showed a 24 hour excretion of 200mg. A diagnosis of protein-losing enteropathy was made by abnormal excretion of ¹²⁵I-polyvinylpyrrolidone. Endoscopic intestinal biopsies revealed edema, mild mononuclear cell infiltration, mildly dilated lymphatic vessels and deposits of C3 and fibrinogen in the walls of capillaries in the lamina propria of villi. Her protein-losing enteropathy responded to high-dose corticosteroid therapy. Lymphatic vessels remained dilated after resolution of protein-losing enteropathy. These findings suggest that increased capillary permeability may be the cause of protein-losing enteropathy in this case.