Primary intestinal lymphangiectasia with generalized warts

World J Gastroenterol. 2015 Jul 21;21(27):8467-72. doi: 10.3748/wjg.v21.i27.8467.

Abstract

Primary intestinal lymphangiectasia (PIL) is a rare protein-losing enteropathy with lymphatic leakage into the small intestine. Dilated lymphatics in the small intestinal wall and mesentery are observed in this disease. Laboratory tests of PIL patients revealed hypoalbuminemia, lymphocytopenia, hypogammaglobulinemia and increased stool α-1 antitrypsin clearance. Cell-mediated immunodeficiency is also present in PIL patients because of loss of lymphocytes. As a result, the patients are vulnerable to chronic viral infection and lymphoma. However, cases of PIL with chronic viral infection, such as human papilloma virus-induced warts, are rarely reported. We report a rare case of PIL with generalized warts in a 36-year-old male patient. PIL was diagnosed by capsule endoscopy and colonoscopic biopsy with histological tissue confirmation. Generalized warts were observed on the head, chest, abdomen, back, anus, and upper and lower extremities, including the hands and feet of the patient.

Keywords: Cell-mediated immunodeficiency; Lymphocytopenia; Primary intestinal lymphangiectasia; Protein-losing enteropathy; Warts.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Capsule Endoscopy
  • Chronic Disease
  • Colonoscopy
  • Diet, Fat-Restricted
  • Dietary Proteins / administration & dosage
  • Humans
  • Immunocompromised Host*
  • Immunohistochemistry
  • Lymphangiectasis, Intestinal / complications*
  • Lymphangiectasis, Intestinal / diagnosis
  • Lymphangiectasis, Intestinal / diet therapy
  • Lymphangiectasis, Intestinal / immunology
  • Lymphedema / complications*
  • Lymphedema / diagnosis
  • Lymphedema / diet therapy
  • Lymphedema / immunology
  • Male
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / immunology
  • Opportunistic Infections / virology*
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / immunology
  • Papillomavirus Infections / virology*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Triglycerides / administration & dosage
  • Warts / diagnosis
  • Warts / immunology
  • Warts / virology*

Substances

  • Dietary Proteins
  • Triglycerides

Supplementary concepts

  • Waldmann disease