title: [Protein-losing enteropathy with systemic lupus erythematosus effectively treated with octreotide and medium chain triglyceride diet: A case report].
abstract: In January 2009, a 62-year-old man presented with diarrhea, leg edema, and thrombopenia and was admitted to our hospital. The past medical history revealed Sjögren's syndrome and autoimmune hepatitis for which he had been administered prednisolone. On admission, a laboratory examination revealed massive hypoalbuminemia and high levels of C-reactive protein and platelet-associated IgG. Anti-double stranded DNA and anti-Sm antibodies were negative. Analysis of the bone marrow aspirate and Tc-99m albumin scintigraphy findings suggested autoimmune thrombocytopenic purpura (AITP) and protein-losing enteropathy (PLE), respectively. We diagnosed him as SLE, because past immunoserological testing had showed positivity for anti-double stranded DNA antibody and LE cells. Methylprednisolone pulse therapy and intravenous immunoglobulin therapy were ineffective. Rituximab was ineffective against PLE but was effective against AITP. Cyclosporine and Cyclophosphamide were ineffective against PLE. Subcutaneous injection of 200-μg octreotide daily and a medium chain triglyceride (MCT) diet was effective against PLE, and the patient's condition dramatically improved. The effectiveness of octreotide treatment and an MCT diet in the treatment of PLE with SLE is discussed.
authors.affiliation: Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kubo
authors.forename: Kousuke
authors.initials: K
authors.lastname: Uchida
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Nakashima
authors.forename: Seiko
authors.initials: S
authors.lastname: Oda
authors.forename: Tomomi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Toshiko
authors.initials: T
authors.lastname: Watada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yano
mesh_terms: D004041:Dietary Fats; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011504:Protein-Losing Enteropathies / Q000150:complications / Q000188:drug therapy*; D014280:Triglycerides / Q000008:administration & dosage*
chemical_list: D004041:Dietary Fats; D014280:Triglycerides; D015282:Octreotide