A case of malabsorption syndrome with autoantibodies

Abstract

A 50 year-old woman with malabsorption syndrome is herein reported. Before admission, she had complained of digestive organ disorders such as anorexia and caddy stool followed by pleural effusion, ascites and rhabdomyolysis, which was a result of hypoalbuminemia and hypokalemia. Diagnostic imaging-an endoscopic study, ultrasonography and an upper GI series-together revealed edematous changes in the esophagus, stomach and small intestines. Blood chemistry disclosed hypoalbuminemia, hypokalemia, as well as an increase in the LDH, CPK and aldolase levels in the serum. An absorption study showed malabsorption from the intestines. Autoantibodies such as anti-nuclear antibody and anti-DNA antibody were positive.
While cases of SLE and PSS with malabsorption syndrome have been reported, this case was considered to be different from the previously reported cases. However, the presence of hyper-γ-globulinemia with autoantibodies and the dramatic effect of steroid therapy indicated that some autoimmune mechanism may have played a role in the malabsorption of the digestive organs in this case. An increase of plasmacytes with vacuoles and sea-blue histiocytes was also observed in the bone marrow smear.