Fecal clearance of alpha1-antitrypsin with lansoprazole can detect protein-losing gastropathy.
Detecting plasma protein loss from the stomach is quite difficult by measuring fecal alpha1-AT clearance because alpha1-AT is rapidly destroyed in the gastric juice at values below pH 3. We examined protein loss from the stomach using fecal alpha1-AT clearance with lansoprazole, a proton pump inhibitor. A 38-year-old Japanese male presented with hypoproteinemia (total serum protein: 4.4 g/dl). Abdominal scintigraphy using technetium-99m-labeled albumin revealed distinct radioactivity accumulation in the small intestine. It strongly suggested excessive protein loss to the gastrointestinal tract. Although, regular fecal alpha1-AT clearance was within the normal range (<13 ml/day), the fecal alpha1-AT clearance with the administration of lansoprazole was 80.5 ml/day. The results indicated that this method using lansoprazole is simple and useful for detecting protein-losing gastropathy.
Takeda
H
H
Second Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Nishise
S
S
Furukawa
M
M
Nagashima
R
R
Shinzawa
H
H
Takahashi
T
T
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005243:Feces / Q000737:chemistry; D006801:Humans; D006863:Hydrogen-Ion Concentration; D064747:Lansoprazole; D008297:Male; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011504:Protein-Losing Enteropathies / Q000175:diagnosis*; D054328:Proton Pump Inhibitors; D000515:alpha 1-Antitrypsin / Q000032:analysis*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D000515:alpha 1-Antitrypsin; D064747:Lansoprazole; D009853:Omeprazole