Primary intestinal lymphangiectasia in adults – diagnostic and therapeutic challenge

Tatiana Jocic; Olgica Latinovic Bosnjak; Mirjana Zivojinov; Mirjana Stojsic; Jelena Ilic Sabo

doi:10.2298/VSP160210320J

Tatiana Jocic Clinical Center of Vojvodina, Clinic of Gastroenterology and Hepatology
Olgica Latinovic Bosnjak University of Novi Sad, Medical faculty, Novi Sad, Serbia
Mirjana Zivojinov University of Novi Sad, Medical faculty, Novi Sad, Serbia
Mirjana Stojsic
Jelena Ilic Sabo

DOI: https://doi.org/10.2298/VSP160210320J

Keywords: diarrhea;, lympangiectasis;, hypoalbuminemia;, lymphopenia;, protein-losing enteropathies

Abstract

Introduction. Primary intestinal lymphangiectasia is a rare disorder, characterized by abnormal dilation of intestinal lymphatic vessels and extensive enteric loss of lymph rich in plasma proteins, lymphocytes and chylomicrons. The main characteristics of the disease are hypoalbuminemia, hypogammaglobulinemia, lymphocytopenia, and more rarely, the deficit of liposoluble vitamins and anemia. Except for primary, there are secondary lymphangiectasia, associated with celiac disease, malignant, infective and inflammatory diseases of the small intestine, fibrosis, liver and cardiovascular diseases. Case report. A male, 33 years of age, presented for his medical examination suffering from diarrhea and edema. The diagnosis was established upon the histological examination of a small intestine biopsy during double balloon enteroscopy, which revealed changes only in one segment of the intestine examined. Such a finding was later confirmed by the video endoscopy capsule. Conclusion. The diagnosis of intestinal lymphangiectasia is usually established before the age of 3, but it can also be diagnosed in adults. The diagnosis is based on the histological analysis of the intestinal mucosa biopsy, obtained by endoscopic procedures. The diagnosis of primary intestinal lymphangiectasia is also made upon the exclusion of secondary causes.

Author Biographies

Tatiana Jocic, Clinical Center of Vojvodina, Clinic of Gastroenterology and Hepatology

Clinical Centre of Vojvodina, Clinic for gastroenterology and hepatology, Novi Sad, Serbia

Olgica Latinovic Bosnjak, University of Novi Sad, Medical faculty, Novi Sad, Serbia

Clinical Centre of Vojvodina, Clinic for gastroenterology and hepatology, Novi Sad, Serbia

Mirjana Zivojinov, University of Novi Sad, Medical faculty, Novi Sad, Serbia

Clinical centre of Vojvodina, Center for Pathology and Histology, Novi Sad, Serbia

Mirjana Stojsic

Institute of Child and Youth Health Care, Department of Gastroenterohepatology and Nutrition, Novi Sad, Serbia

Jelena Ilic Sabo

Clinical centre of Vojvodina, Center for Pathology and Histology, Novi Sad, Serbia

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