Lymph loss in the bowel and severe nutritional disturbances in Crohn's disease.
A severe nutritional deficiency status is described in a 22-year-old patient with Crohn's disease. The clinical picture on admission was dominated by an episode of gastrointestinal bleeding secondary to clotting disturbances (vitamin K deficiency) and severe cachexia due to a protein energy malnutrition. The mechanisms of severe nutritional disturbances in Crohn's disease are multifactorial. In this patient, lymphatic leakage into the intestinal lumen was a major contributing factor in the pathogenesis of protein-losing enteropathy, fat malabsorption, and lymphocytopenia. The authors were able to demonstrate this intestinal lymph loss by nuclear imaging.
Baert
D
D
Department of Gastroenterology, A.Z. Maria Meddelares, Gent, Belgium.
Wulfrank
D
D
Burvenich
P
P
Lagae
J
J
D000328:Adult; D003424:Crohn Disease / Q000150:complications* / Q000628:therapy; D005234:Fatty Liver / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007019:Hypoproteinemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology; D008196:Lymph / Q000378:metabolism*; D008297:Male; D009748:Nutrition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011379:Prognosis; D012720:Severity of Illness Index