Resolution of protein-losing enteropathy with low-molecular weight heparin in an adult patient with Fontan palliation.
Protein-losing enteropathy is a well-known complication after the Fontan procedure, and unfractionated heparin therapy has been tried with some success as a potential therapy. Low-molecular weight heparin is believed to be ineffective. We now describe a case in which an adult patient with protein-losing enteropathy after Fontan palliation was successfully treated with systemic doses of low-molecular weight heparin, with complete resolution in the 24-hour fecal alpha-1 anti-trypsin level and serum albumin. The patient continues to remain in remission with this therapy. In conclusion, these findings are novel and compel us to re-evaluate our pathophysiologic understanding of this difficult condition.
Bhagirath
Kapil M
KM
Section of Cardiology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. umbhagir@cc.umanitoba.ca
Tam
James W
JW
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D010166:Palliative Care; D011504:Protein-Losing Enteropathies / Q000188:drug therapy*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight