title: An exotic cause of exudative enteropathy.
abstract: METHODS
  Male, 50 FINAL DIAGNOSIS: Exudative enteropathy Symptoms: Abdominal pain • diarrhea • fever • hyponatremia • lymphadenopathy • weight loss
  
  
  METHODS
  - Clinical Procedure: - Specialty: -
  
  
  OBJECTIVE
  Unusual clinical course.
  
  
  BACKGROUND
  Protein-losing enteropathy is a rare cause of hypoproteinemia. Erosive and non-erosive gastrointestinal diseases as well as vascular disorders that result in increased central venous pressure or mesenteric lymphatic obstruction may result in protein loss via the gastrointestinal tract.
  
  
  METHODS
  We present the case of a 50-year-old man with protein-losing enteropathy, who had profuse diarrhea, abdominal pain, lymphadenopathy, fever, and a weight loss of 10 kg in the preceding 2 months. Extensive work-up revealed infection with Giardia lamblia. We review clinical signs and symptoms, laboratory findings, and imaging studies, and discuss potential pitfalls in establishing the diagnosis.
  
  
  CONCLUSIONS
  To the best of our knowledge, this represents one of the few published cases of intestinal giardiasis as a cause of protein-losing enteropathy in an immunocompetent adult. The diagnosis of lambliasis should be based on a combination of stool cultures and serum serology, and in cases of high clinical suspicion, an endoscopy and biopsy of the upper GI tract is recommended.
authors.affiliation: Department of Endocrinology, Diabetes and Bone Diseases, University Clinic Dresden, Dresden, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Tsourdi
authors.affiliation: Department of Internal Medicine and Cardiology, Herzzentrum University Hospital, University Clinic Dresden, Dresden, Germany.
authors.forename: Felix M
authors.initials: FM
authors.lastname: Heidrich
authors.affiliation: Department of Endocrinology, Diabetes and Bone Diseases, University Clinic Dresden, Dresden, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Winzer
authors.affiliation: Department of Haematology, University Clinic Dresden, Dresden, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Röllig
authors.affiliation: Department of Gastroenterology, University Clinic Dresden, Dresden, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kirsch
authors.affiliation: Department of Pathology, University Clinic Dresden, Dresden, Germany.
authors.forename: Jörn
authors.initials: J
authors.lastname: Meinel
authors.affiliation: Department of Pathology, University Clinic Dresden, Dresden, Germany.
authors.forename: Gustavo B
authors.initials: GB
authors.lastname: Baretton
authors.affiliation: Department of Endocrinology, Diabetes and Bone Diseases, University Clinic Dresden, Dresden, Germany.
authors.forename: Stefan R
authors.initials: SR
authors.lastname: Bornstein
authors.affiliation: Department of Endocrinology, Diabetes and Bone Diseases, University Clinic Dresden, Dresden, Germany.
authors.forename: Lorenz C
authors.initials: LC
authors.lastname: Hofbauer
keywords: Giardia Lamblia – pathogenicity; Protein-Losing Enteropathies – diagnosis; Protein-Losing Enteropathies – etiology; Protein-Losing Enteropathies – parasitology; Protein-Losing Enteropathies – therapy