Protein-losing enteropathies.
GI protein loss can result from a heterogeneous group of diseases, including lymphangiectasia, IBD, neoplasia, ulceration, intussusception, and histoplasmosis. PLE should be suspected in any hypoalbuminemic patient with no evidence of exudative protein loss, proteinuria, or HI. A minimum laboratory database for the suspected PLE patient should include a complete blood cell count, a biochemical and electrolyte profile, urinalysis (+/- urine protein:cretinine ratio), and pre- and postprandial bile acid determinations. Fecal alpha 1-PI concentrations may be used to confirm the presence of GI protein loss in cases with concurrent renal or hepatic disease. Because PLE is a syndrome and not a specific disease, the most effective therapy must be directed at the underlying cause. Multiple high-quality endoscopic biopsies are sufficient to diagnose most patients with PLE, although full-thickness biopsies are required in some cases. Patients with PLE are often clinically "fragile," and careful symptomatic therapy must be integrated with dietary and medical management strategies in most cases.
Peterson
Polly B
PB
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, 4474 TAMU, Texas A&M University, College Station, TX 77843-4474, USA.
Willard
Michael D
MD
D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis* / Q000178:diet therapy / Q000209:etiology / Q000628:therapy*; D004285:Dogs; D011504:Protein-Losing Enteropathies / Q000175:diagnosis / Q000628:therapy / Q000662:veterinary*