A case report of Sjögren's syndrome associated with protein-losing gastroenteropathy successfully treated with methylprednisolone

J Int Med Res. 2020 Feb;48(2):300060519874543. doi: 10.1177/0300060519874543. Epub 2019 Oct 8.

Abstract

Protein-losing gastroenteropathy (PLGE) is a rare manifestation of primary Sjögren's syndrome that is most commonly reported in Japan. Herein, the case of a 71-year-old Chinese male patient, diagnosed with PLGE and Sjögren's syndrome, is reported. The patient presented with peripheral oedema, and PLGE was diagnosed based on the result of technetium-99m (99mTc)-labelled albumin scintigraphy. In addition to a positive Schirmer's test, the patient had atrophy of the salivary gland with lymphocyte infiltration, impaired parotid-gland secretory and excretory function, and an increased level of anti-SSA antibodies, fulfilling the criteria for Sjögren's syndrome. He was successfully treated with methylprednisolone. Follow-up 99mTc-labelled albumin scintigraphy results correlated well with clinical improvement and increased serum albumin levels. The present case study highlights the necessity of considering a diagnosis of protein loss enteropathy associated with primary Sjögren's syndrome when patients have unexplained hypoproteinaemia.

Keywords: 99mTc-labelled albumin scintigraphy; Protein-losing enteropathy; case report; immunosuppressive drugs; primary Sjögren’s syndrome.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents* / therapeutic use
  • Humans
  • Japan
  • Male
  • Methylprednisolone* / therapeutic use
  • Parotid Gland
  • Salivary Glands / diagnostic imaging
  • Sjogren's Syndrome* / complications
  • Sjogren's Syndrome* / drug therapy

Substances

  • Anti-Inflammatory Agents
  • Methylprednisolone