title: Protein-losing enteropathy in an infant with rotavirus infection.
abstract: Protein-losing enteropathy (PLE) is a rare gastro-intestinal complication characterised by intestinal loss of proteins with consequent hypoproteinaemia and generalised oedema. Rotavirus infection associated with PLE in children has rarely been reported. A 6-month-old girl presented with diarrhoea, fever and generalised oedema. Total serum proteins were 34 g/L (61-79) and plasma albumin 16.8 g/L (40-50), serum sodium was 126 mmol/L and there was mild metabolic alkalosis (pH 7.46). Stool for alpha-1 antitrypsin was >1.2 mg/g (<0.6) which supported the diagnosis of PLE. Stool examination demonstrated the presence of rotavirus antigen by the rapid immunochromatographic test. Abdominal ultrasound showed bowel distension and intestinal wall thickening with a small amount of ascites. Echocardiography excluded pericardial effusion. Two albumin infusions (1 g/kg) were required to sustain normal serum albumin levels. Over the next 2 weeks, there was gradual normalisation of stools and progressive reduction of oedema. In children with acute and symptomatic PLE, rotavirus should be considered in the differential diagnosis. The availability of the rapid immunochromatographic test facilitates the diagnosis. In most cases, supportive care alone is sufficient, but albumin infusions may be required in more severely affected children.
authors.affiliation: a Department of Paediatrics , University of Chieti , Chieti , Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Parisi
authors.affiliation: a Department of Paediatrics , University of Chieti , Chieti , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cafarotti
authors.affiliation: a Department of Paediatrics , University of Chieti , Chieti , Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Salvatore
authors.affiliation: a Department of Paediatrics , University of Chieti , Chieti , Italy.
authors.forename: Piernicola
authors.initials: P
authors.lastname: Pelliccia
authors.affiliation: a Department of Paediatrics , University of Chieti , Chieti , Italy.
authors.forename: Luciana
authors.initials: L
authors.lastname: Breda
authors.affiliation: a Department of Paediatrics , University of Chieti , Chieti , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000418:Albumins / Q000008:administration & dosage; D000956:Antigens, Viral / Q000032:analysis; D002846:Chromatography, Affinity; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D010949:Plasma / Q000737:chemistry; D011504:Protein-Losing Enteropathies / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D012401:Rotavirus / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000150:complications*; D012709:Serum Albumin / Q000032:analysis; D014463:Ultrasonography
chemical_list: D000418:Albumins; D000956:Antigens, Viral; D012709:Serum Albumin
keywords: Rotavirus; child; oedema; protein-losing enteropathy