Idiopathic Protein Losing Enteropathy (PLE)

IDIOPATHIC PROTEIN LOSING ENTEROPATHY in a 43y/o Caucasian Male.

Mr. Taverne was diagnosed with (PLE) in the fall of 2002. He presented in the ER with c/o dependant edema of scrotum and lower extremities.

Blood workup noted a marked deficiency of Album <1 and a total serum protein of 2.0

The pt was referred to the Veteran’s Administration for tx.

I have had EGDs, colonoscopies, small bowel full thickness biopsies, gastric biopsies. All of which showed nothing remarkable. At the Mayo clinic, however, a doctor did make the diagnosis of Menetrier’s disease which is also known as hypertrophic gastropathy.

The VA was unable to confirm this diagnosis. However, the VA did prescribe the recommended tx which was subcutaneous octreotide (sandistatin) injections. This rx yielded marginal results which seemed to decrease over the course of a few months.

Prior to the octreotide, I had gone the prednisone route, the amuran, cytoxan, humera and others, It seemed the prednisone did some good keeping my protein up some, but the side effects were terrible. The Humera seemed to work very well keeping my Albumin above 2 for about a year. I then had a positive AFB in my spinal fluid which meant I’d have to be worked up and treated for tuberculosis meningitis.

My spleen clotted, and I had to have it removed after about a week. I had to have bypass surgery on my leg after I seemed to develop a neuropathy, as well as a circulation issue. My toes started turning black, and they hurt like crazy. I also developed 2 sores on the bottom of that same foot. Eventually, the toes had to be taken off, and the sores cleaned out. These procedures were performed after the bypass (femoral to distal) was deemed a success.

I had plural effusions in 2009. The doctor went to drain the plural space when he hit an artery in my lung. I almost died., but I pulled through.

I had a miraculous spike in my protein that month (June) that lasted about 2 months. It’s unclear what caused it.

I’m of the feeling that it was due to a combination of factors. 1. I didn’t eat very much during that time. 2. I was given upwards of 6 units of whole blood. There might be a few other factors such as phosphorous tablets.

The doctor recently had me try taking Budesonide which is a new tx for irritable bowel syndrome. I developed severe abdominal pains and a whole lot of gas.