1986 Volume 17 Issue 4 Pages 557-562
A 71 year-old man was admitted for the closer examination of hypoproteinemia, which was noted at the age of 54. On admission lower limbs were edematous. Serum protein was 4.1g/dl and albumin 2.0g/dl. Urinalysis and liver function tests were negative. The half life of ^<131>I-albumin is shortened to 6.1days. Protein-losing enteropathy was suspected and intestinal clearance of α_1-antitrypsin (α_1-AT) was determined. Fecal content of α_1-AT and α_1-AT clearance rate were 1422mg/day and 569ml/day respectivity, which were remarkably high. These findings suggested plasma protein was leaking into the intestinal tract. Roentogenological study of the jejunum revealed coarse mucosal pattern and biopsy showed dilatation of lymphatic vessels. Lymphography demonstrated no abnormality. Diagnosis of primary proteinlosing enteropathy was done. Measurement of α_1-AT clearance was useful in establishing the diagnosis.
