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Is portal hypertension associated with protein‐losing enteropathy?
Author(s) -
GEORGOPOULOS PHILIPPOS,
MOWAT CRAIG,
MCMILLAN DONALD C,
KINGSTONE KATHLEEN,
GHOSH SUBRATA,
STANLEY ADRIAN J
Publication year - 2005
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2004.03475.x
Subject(s) - hypoalbuminemia , medicine , albumin , gastroenterology , protein losing enteropathy , cirrhosis , enteropathy , serum albumin , liver disease , disease
Background and Aim: Hypoalbuminemia in patients with decompensated cirrhosis has traditionally been assumed to be a result of to impaired liver synthesis; however, protein‐losing enteropathy (PLE) may also contribute. The aim of this study was to assess whether hypoalbuminemic cirrhotic patients with portal hypertension had evidence of PLE. Methods: Sixteen patients with alcoholic cirrhosis, hypoalbuminemia and portal hypertension underwent whole gut lavage with polyethylene glycol solution. The effluent obtained was analyzed for albumin, immunoglobulin (Ig)G and α1‐antitrypsin (α1‐AT). Serum C‐reactive protein (CRP) was also measured to assess the systemic inflammatory response. Results: Twelve of the 16 enrolled patients had a persistently low albumin concentration at the time of lavage. Only one patient (who was subsequently found to have celiac disease) had elevated concentrations of lavage albumin, α1‐AT and IgG levels. There was a significant correlation between lavage albumin and α1‐AT ( r = 0.671, P = 0.024), and between lavage albumin and IgG ( r = 0.614, P = 0.045). There was no correlation between serum albumin and lavage proteins. Six patients had elevated serum CRP levels, but serum albumin or lavage protein concentrations did not correlate with serum CRP. Conclusion: There is no evidence of a significant PLE in patients with alcoholic cirrhosis, hypoalbuminemia and portal hypertension.