Atypical clinical presentation of crohn’s disease with superior mesenteric vein obstruction and protein-losing enteropathy

Suguru Ito; Masaaki Higashiyama; Kazuki Horiuchi; Akinori Mizoguchi; Shigeyoshi Soga; Rina Tanemoto; Shin Nishii; Hisato Terada; Akinori Wada; Nao Sugihara; Yoshinori Hanawa; Hirotaka Furuhashi; Takeshi Takajo; Kazuhiko Shirakabe; Chikako Watanabe; Shunsuke Komoto; Kengo Tomita; Shigeaki Nagao; Masami Shinozaki; Akihiko Nakagawa; Michio Kubota; Daisuke Miyagishima; Nobuaki Gotoh; Soichiro Miura; Hideki Ueno; Ryota Hokari

doi:10.2169/internalmedicine.1192-18

Atypical clinical presentation of crohn’s disease with superior mesenteric vein obstruction and protein-losing enteropathy

Suguru Ito, Masaaki Higashiyama, Kazuki Horiuchi, Akinori Mizoguchi, Shigeyoshi Soga, Rina Tanemoto, Shin Nishii, Hisato Terada, Akinori Wada, Nao Sugihara, Yoshinori Hanawa, Hirotaka Furuhashi, Takeshi Takajo, Kazuhiko Shirakabe, Chikako Watanabe, Shunsuke Komoto, Kengo Tomita, Shigeaki Nagao, Masami Shinozaki, Akihiko NakagawaMichio Kubota, Daisuke Miyagishima, Nobuaki Gotoh, Soichiro Miura, Hideki Ueno, Ryota Hokari

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

We herein report a 44-year-old man suffering from systemic edema due to protein-losing enteropathy (PLE) with superior mesenteric vein (SMV) obstruction and development of collateral veins, which subsequently proved to be a chronic result of thrombosis and a complication of Crohn’s disease (CD). PLE was supposedly induced by both intestinal erosion and thrombosis-related lymphangiectasia, which was histologically proven in his surgically-resected ileal stenosis. Elemental diet and anti-TNFα agent improved his hypoalbuminemia after surgery. The rarity of the simultaneous coexistence of SMV obstruction and PLE and the precedence of these complications over typical abdominal symptoms of CD made the clinical course complex.

Original language	English
Pages (from-to)	369-374
Number of pages	6
Journal	Internal Medicine
Volume	58
Issue number	3
DOIs	https://doi.org/10.2169/internalmedicine.1192-18
Publication status	Published - 2019
Externally published	Yes

Keywords

Crohn’s disease (CD)
Mesenteric vein thrombosis
Protein-losing enteropathy (PLE)

ASJC Scopus subject areas

Internal Medicine

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10.2169/internalmedicine.1192-18

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Ito, S., Higashiyama, M., Horiuchi, K., Mizoguchi, A., Soga, S., Tanemoto, R., Nishii, S., Terada, H., Wada, A., Sugihara, N., Hanawa, Y., Furuhashi, H., Takajo, T., Shirakabe, K., Watanabe, C., Komoto, S., Tomita, K., Nagao, S., Shinozaki, M., ... Hokari, R. (2019). Atypical clinical presentation of crohn’s disease with superior mesenteric vein obstruction and protein-losing enteropathy. Internal Medicine, 58(3), 369-374. https://doi.org/10.2169/internalmedicine.1192-18

Ito, S, Higashiyama, M, Horiuchi, K, Mizoguchi, A, Soga, S, Tanemoto, R, Nishii, S, Terada, H, Wada, A, Sugihara, N, Hanawa, Y, Furuhashi, H, Takajo, T, Shirakabe, K, Watanabe, C, Komoto, S, Tomita, K, Nagao, S, Shinozaki, M, Nakagawa, A, Kubota, M, Miyagishima, D, Gotoh, N, Miura, S, Ueno, H & Hokari, R 2019, 'Atypical clinical presentation of crohn’s disease with superior mesenteric vein obstruction and protein-losing enteropathy', Internal Medicine, vol. 58, no. 3, pp. 369-374. https://doi.org/10.2169/internalmedicine.1192-18

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title = "Atypical clinical presentation of crohn{\textquoteright}s disease with superior mesenteric vein obstruction and protein-losing enteropathy",

abstract = "We herein report a 44-year-old man suffering from systemic edema due to protein-losing enteropathy (PLE) with superior mesenteric vein (SMV) obstruction and development of collateral veins, which subsequently proved to be a chronic result of thrombosis and a complication of Crohn{\textquoteright}s disease (CD). PLE was supposedly induced by both intestinal erosion and thrombosis-related lymphangiectasia, which was histologically proven in his surgically-resected ileal stenosis. Elemental diet and anti-TNFα agent improved his hypoalbuminemia after surgery. The rarity of the simultaneous coexistence of SMV obstruction and PLE and the precedence of these complications over typical abdominal symptoms of CD made the clinical course complex.",

keywords = "Crohn{\textquoteright}s disease (CD), Mesenteric vein thrombosis, Protein-losing enteropathy (PLE)",

author = "Suguru Ito and Masaaki Higashiyama and Kazuki Horiuchi and Akinori Mizoguchi and Shigeyoshi Soga and Rina Tanemoto and Shin Nishii and Hisato Terada and Akinori Wada and Nao Sugihara and Yoshinori Hanawa and Hirotaka Furuhashi and Takeshi Takajo and Kazuhiko Shirakabe and Chikako Watanabe and Shunsuke Komoto and Kengo Tomita and Shigeaki Nagao and Masami Shinozaki and Akihiko Nakagawa and Michio Kubota and Daisuke Miyagishima and Nobuaki Gotoh and Soichiro Miura and Hideki Ueno and Ryota Hokari",

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year = "2019",

doi = "10.2169/internalmedicine.1192-18",

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pages = "369--374",

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T1 - Atypical clinical presentation of crohn’s disease with superior mesenteric vein obstruction and protein-losing enteropathy

AU - Ito, Suguru

AU - Higashiyama, Masaaki

AU - Horiuchi, Kazuki

AU - Mizoguchi, Akinori

AU - Soga, Shigeyoshi

AU - Tanemoto, Rina

AU - Nishii, Shin

AU - Terada, Hisato

AU - Wada, Akinori

AU - Sugihara, Nao

AU - Hanawa, Yoshinori

AU - Furuhashi, Hirotaka

AU - Takajo, Takeshi

AU - Shirakabe, Kazuhiko

AU - Watanabe, Chikako

AU - Komoto, Shunsuke

AU - Tomita, Kengo

AU - Nagao, Shigeaki

AU - Shinozaki, Masami

AU - Nakagawa, Akihiko

AU - Kubota, Michio

AU - Miyagishima, Daisuke

AU - Gotoh, Nobuaki

AU - Miura, Soichiro

AU - Ueno, Hideki

AU - Hokari, Ryota

PY - 2019

Y1 - 2019

N2 - We herein report a 44-year-old man suffering from systemic edema due to protein-losing enteropathy (PLE) with superior mesenteric vein (SMV) obstruction and development of collateral veins, which subsequently proved to be a chronic result of thrombosis and a complication of Crohn’s disease (CD). PLE was supposedly induced by both intestinal erosion and thrombosis-related lymphangiectasia, which was histologically proven in his surgically-resected ileal stenosis. Elemental diet and anti-TNFα agent improved his hypoalbuminemia after surgery. The rarity of the simultaneous coexistence of SMV obstruction and PLE and the precedence of these complications over typical abdominal symptoms of CD made the clinical course complex.

AB - We herein report a 44-year-old man suffering from systemic edema due to protein-losing enteropathy (PLE) with superior mesenteric vein (SMV) obstruction and development of collateral veins, which subsequently proved to be a chronic result of thrombosis and a complication of Crohn’s disease (CD). PLE was supposedly induced by both intestinal erosion and thrombosis-related lymphangiectasia, which was histologically proven in his surgically-resected ileal stenosis. Elemental diet and anti-TNFα agent improved his hypoalbuminemia after surgery. The rarity of the simultaneous coexistence of SMV obstruction and PLE and the precedence of these complications over typical abdominal symptoms of CD made the clinical course complex.

KW - Crohn’s disease (CD)

KW - Mesenteric vein thrombosis

KW - Protein-losing enteropathy (PLE)

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Atypical clinical presentation of crohn’s disease with superior mesenteric vein obstruction and protein-losing enteropathy

Abstract

Keywords

ASJC Scopus subject areas

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