A case of protein-losing gastroenteropathy due to Sjögren's syndrome detected by foggy vision with refractive error of the intraocular lens.

Autor: Watanabe N; Department of Gastroenterology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan.; Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan., Kaneko R; Department of Gastroenterology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan. rena@kantoh.johas.go.jp., Kishi M; Department of Pathology and Diagnostics, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Japan., Yanai R; Division of Rheumatology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan., Ikehara T; Department of Gastroenterology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510, Japan.; Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan., Nagai H; Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan., Matsuda T; Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Jazyk: angličtina
Zdroj: Clinical journal of gastroenterology [Clin J Gastroenterol] 2024 Dec; Vol. 17 (6), pp. 1039-1046. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1007/s12328-024-02038-2
Abstrakt: A woman in her forties visited an ophthalmologist for rapidly progressive foggy vision. Naked visual acuity had decreased to 0.15, and although her eyes showed no abnormalities, internal disease was suspected and albumin 2.6 g/dL was found. Protein leakage from the intestinal tract was suspected since there was no urinary protein excretion. 99m Technetium-labeled albumin D scintigraphy showed protein leakage from the intestinal tract. A stool α1-antitrypsin clearance test showed an increase to 56.3 mL/day, leading to a diagnosis of protein-losing gastroenteropathy. Blood biochemistry revealed abnormally high levels of anti-SS-A and anti-SS-B antibodies (≥ 1200 U/mL and ≥ 1000 U/mL, respectively). A lip salivary gland biopsy revealed lymphocytic infiltrate at least 1 focus per 2 mm × 2 mm > 50 lymphocytes per conduit). The Schirmer test result was 5 mm/5 min or less, which led to the diagnosis of Sjögren's syndrome. The serum albumin level increased with intravenous administration of methylprednisolone 50 mg (1 mg/kg), and the patient is currently on oral prednisolone at a gradually decreasing dose. After administration of prednisolone, visual acuity recovered to 1.2 with recovery of albumin.
(© 2024. Japanese Society of Gastroenterology.)
Databáze: MEDLINE
Externí odkaz: