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November 22, 1965

Chronic Hypoalbuminemia and Edema Associated With Intestinal Lymphangiectasia

Author Affiliations

From the departments of pathology (Dr. Fadell) and medicine (Drs. Dame and Wolford), Methodist Evangelical Hospital, Louisville.

JAMA. 1965;194(8):917-918. doi:10.1001/jama.1965.03090210081030

THE PRESENCE of edema with associated hypoproteinemia in a person who has no manifest renal or liver disease should alert one to the possibility that loss of protein into the intestines may be causative. Increased protein loss into the gut has been demonstrated in a variety of inflammatory and neoplastic diseases of the gastrointestinal tract. Diseases associated with this have been designated protein-losing gastroenteropathies or hypercatabolic protein-losing enteropathies. This category includes celiac disease, sprue, acute gastroenteritis, regional enteritis, ulcerative colitis, intestinal lipodystrophy (Whipple's Disease), Menetrier's disease, and intestinal lymphangiectasia.

The use of radioisotopes has clarified the site of loss of serum albumin, and the introduction of the biopsy tube for the small intestine has made tissue available for study of the underlying pathological abnormality.

Report of a Case  The patient, a 52-year-old white woman was first admitted to Methodist Evangelical Hospital on Dec 8, 1962. Her illness dates back approximately