Constrictive Pericarditis and Protein-Losing Enteropathy
Is Extremely Severe Hypoalbuminemia Reversible by Pericardiectomy?
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Protein-losing enteropathy is characterized by excessive loss of serum proteins into the gastrointestinal tract and is a rare complication of constrictive pericarditis.1 Pericardiectomy, although a radical treatment, is the definitive therapy for constrictive pericarditis. Despite the effectiveness of pericardiectomy in treating constrictive pericarditis, its effectiveness in reversing extremely severe hypoalbuminemia with protein-losing enteropathy has not been established. In addition, treating physicians may question whether such cases are beyond the treatment window for pericardiectomy. Here, we report a case of protein-losing enteropathy caused by constrictive pericarditis, in which pericardiectomy lead to remarkable improvement in extremely severe hypoalbuminemia.
A 38-year-old male patient who had previously undergone mitral valve replacement for severe mitral regurgitation and infective endocarditis 12 years prior presented with progressive diarrhea, edema of both lower extremities, and significant weight gain over the past 6 years. In addition to hypoalbuminemia without nephrotic syndrome, liver cirrhosis, or malnutrition, technetium 99 m–labeled human serum albumin-diethylene-triaminepenta-acetic acid abdominal scintigraphy revealed accumulation of radionuclide in the …