Use of heparin in the treatment of protein-losing enteropathy after fontan operation for complex congenital heart disease.
Protein-losing enteropathy (PLE) is a serious complication of the Fontan operation and is associated with pronounced mortality. Medical management of PLE has been only partially successful. A recent report noted dramatic improvement in patients with PLE within 3 weeks of subcutaneous administration of heparin. We report a case of reversal of PLE with resolution of clinical symptoms and normalization of serum albumin, total protein, and fecal alpha1-antitrypsin values after several months of heparin treatment. Our findings substantiate those recently reported but suggest that reversal of PLE may necessitate more than a few weeks of heparin therapy.
Kelly
A M
AM
Department of Pediatric and Adolescent Medicine, Mayo Clinic Rochester, Minnesota 55905, USA.
Feldt
R H
RH
Driscoll
D J
DJ
Danielson
G K
GK
D000279:Administration, Cutaneous; D000328:Adult; D001798:Blood Proteins / Q000187:drug effects* / Q000378:metabolism; D018729:Fontan Procedure / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011504:Protein-Losing Enteropathies / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D012709:Serum Albumin / Q000187:drug effects; D000515:alpha 1-Antitrypsin / Q000187:drug effects* / Q000378:metabolism
D001798:Blood Proteins; D012709:Serum Albumin; D000515:alpha 1-Antitrypsin; D006493:Heparin