ABSTRACT
Protein-losing enteropathy (PLE), defined as the abnormal loss of protein from the gastrointestinal tract, occurs in many diseases through pathologic processes that involve the enteric, vascular, and lymphatic systems. The cardinal features of PLE are edema and hypoalbuminemia, lymphopenia, and loss of T cells and immunoglobulins. Asymmetric peripheral edema may signify a lymph disorder that precedes PLE. Growth retardation is common in chronic cases of PLE. In general, manifestations are variable and depend on the underlying disease processes. The Fontan procedure is a well-known precursor of PLE, which sometimes appears years after the procedure itself. Erosion, ulceration, and inflammation of the intestinal mucosa causing PLE may be the result of infectious or noninfectious disorders. PLE is very occasionally a feature associated with cow’s milk protein allergy. A child with edema and hypoalbuminemia, who is otherwise well-nourished and who does not have renal or liver disease, should undergo evaluation for PLE.
