Protein-losing gastroenteropathy in a patient with concomitant systemic lupus erythematosus and Sjögren’s syndrome

Mizuna EguchiDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Nozomi IwanagaDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan; ;Department of Rheumatology, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Kosuke SakaiDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Tohru MichitsujiDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Yoshika TsujiDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan; ;Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan;

Chieko KawaharaDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Hitomi KobayashiDepartment of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Yoshiro HoraiDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan; ;Department of Rheumatology, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan; ;Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan; Correspondence[email protected]

Takahiro MoriDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Yasumori IzumiDepartment of General and Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Masahiro ItoClinical Research Center, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan; ;Department of Pathology, National Hospital Organization Nagasaki Medical Center, Omura, Nagasaki, Japan;

Atsushi KawakamiDivision of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

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Abstract

We report a female in her twenties who developed generalized edema. She was diagnosed as systemic lupus erythematous (SLE) and Sjögren’s syndrome (SS) based on her physical manifestations and positive findings for antinuclear antibody and anti-SS-A/SS-B-antibody. Although she manifested hypoproteinemia, a possibility of lupus nephritis was denied due to a lack of significant abnormality in kidney function tests and urinalysis. The nature of hypoproteinemia and related symptoms was identified as protein losing gastroenteropathy (PLGE) based on α 1-antitrypsin clearance and histopathology findings. Physicians should be aware that PLGE may develop as an underlying cause of edema in SLE and SS.

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Protein-losing gastroenteropathy in a patient with concomitant systemic lupus erythematosus and Sjögren’s syndrome

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Protein-losing gastroenteropathy in a patient with concomitant systemic lupus erythematosus and Sjögren’s syndrome

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