All issues > Volume 44(5); 2001

Case Report

J Korean Pediatr Soc. 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 JW Choi¹

¹Department of Pediatrics, Pundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea

Correspondence Jong-Woon JW Choi ,Email: cjw@dmc.or.kr

Abstract

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.

Keywords :Protein-losing enteropathy, Congestive heart failure, Technetium-99m-labeled albumin, Prednisolone