Clostiridium difficile enfeksiyonuna eşlik eden protein kaybettiren enteropati olgusu

Öz

Protein kaybettiren enteropati, plazma proteinlerinin lenfatik obstrüksiyon, sağ kalp basıncının arttığı kalp hastalıkları ve gastrointestinal sistemden kaybı ile karakterize nadir görülen bir hastalıktır. Primer intestinal lenfanjiektazi protein kaybettiren enteropatinin en sık nedeni olmakla birlikte Giardia intestinalis, Clostiridium difficile gibi pek çok parazitik enfeksiyonlar, inflamatuvar barsak hastalığı, çölyak, malignite, kardiyak hastalıklar ve kollajen doku hastalıklarının protein kaybettiren enteropatiye neden olduğu bilinmektedir. Clostiridium difficile antibiyotik ilişkili kolitin en önemli enfeksiyonlarından biri olup semptomatik ya da asemptomatik olabilir. Sulu ishal, karın ağrısı sık klinik bulgu iken bazı olgularda barsak duvarının enflamasyonu ve kolon lümeninin içerisine albümin sızması ile ilişkili olarak hipoalbüminemi ve ödem diğer klinik bulguları oluşturmaktadır. Bize antibiyotik kullanımı sonrası ishal, ödem kliniği ile başvuran, laboratuvar ve histopatolojik olarak lenfanjiektazi ile uyumlu saptanan olgu, protein kaybettiren enteropati olarak değerlendirildi. Az sayıda literatürde Clostiridium difficile enfeksiyonuna bağlı protein kaybettiren enteropati geliştiği bildirildiğinden bu olgu sunulmak istendi.

Anahtar Kelimeler

• Protein kaybettiren enteropati
• Clostiridium difficile
• alfa-1 antitripsin
• lenfanjiektazi

Protein-losing enteropathy associated with Clostiridium difficile infection: A case report

Öz

Protein-losing enteropathy is a rare disease characterized by lymphatic obstruction, heart disease with increased right heart pressure, and loss of proteins through the gastrointestinal tract. Although primary intestinal lymphangiectasia is the most common cause of protein-losing enteropathy, many parasitic infections such as Giardia intestinalis, Clostridium difficile, inflammatory bowel diseases, celiac diseases, malignancies, cardiac diseases, and collagen tissue diseases cause protein-losing enteropathy. Clostridium difficile is one of the most important causes of antibiotic-associated colitis, and it can be either symptomatic or asymptomatic. Although watery diarrhea and abdominal pain are common clinical findings, in some cases, hypoalbuminemia and edema are other clinical findings associated with inflammation of the intestinal wall and albumin leakage into the lumen of the colon. The patient who presented to us with diarrhea and edema after using antibiotics, their case was found to be laboratory and histopathologically compatible with lymphangiectasia, and it was evaluated as protein-losing enteropathy. Here, we present this case because of the scant reports of protein-losing enteropathy caused by Clostridium difficile infection.

Anahtar Kelimeler

• Protein-losing enteropathy
• Clostridium difficile
• alpha-1 antitrypsin
• lymphangiectasia

Kaynakça

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