Protein-Losing Enteropathy

Protein-losing enteropathy (PLE) refers to a pathologic loss of protein from the gastrointestinal tract. PLE may result from a variety of both intra- and extraintestinal diseases. Patients present with symptomatic hypoalbuminemia leading to peripheral edema, pleural and pericardial effusions, and malnutrition sometimes in the context of symptoms of abdominal pain and diarrhea. PLE should be suspected in patients with low serum albumin after ruling out acute illness, dilutional hypoalbuminemia, renal losses, and synthetic dysfunction. Calculation of fecal alpha-1-antitrypsin clearance is the test of choice for diagnosis. While many treatments have been reported, the cornerstone of therapy centers on treating the underlying cause of the PLE.