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A Case of Protein-losing Enteropathy in Congestive Heart Failure : Resolution with Prednisolone

Journal of the Korean Pediatric Society 2001;44(5):587-591.
Published online May 15, 2001.
A Case of Protein-losing Enteropathy in Congestive Heart Failure : Resolution with Prednisolone
Jong-Woon Choi
Department of Pediatrics, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
부신피질호르몬을 이용한 심부전증에서의 단백소실 장병증 치험 1례
대진의료재단 분당제생병원 소아과
Jong-Woon Choi, Email: cjw@dmc.or.kr
Protein-losing enteropathy can result from primary or secondary intestinal lymphangiectasia. Secondary intestinal lymphangiectasia develops as a result of lymphatic obstruction or elevated lymphatic pressure. Cardiac lesions such as constrictive pericarditis, post-Fontan procedure state, and chronic congestive heart failure increase lymphatic pressure and may cause intestinal lymphangiectasia and protein-losing enteropathy. An 11-year-old girl who underwent corrective surgery for Tetralogy of Fallot at two years of age had been suffering from chronic congestive heart failure, taking digitalis and diuretics. She was afflicted with protein-losing enteropathy nine years after surgery. Diagnosis was made by means of radioisotope scan using technetium-99m-labeled albumin. Symptoms were not improved with diet therapy, so prednisolone was given orally and remission was achieved. Although relapses occurred four times, remission was achieved with prednisolone at each time. Thereafter the patient remained in remission state over one year after discontinuation of prednisolone.
Key Words: Protein-losing enteropathy, Congestive heart failure, Technetium-99m-labeled albumin, Prednisolone

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