Protein-losing enteropathy in paracoccidioidomycosis
Troncon, L.E.; Martinez, R.; Meneghelli, U.G.; de Oliveira, R.B.; Iazigi, N.
Revista do Hospital das Clinicas 36(4): 172-178
1981
ISSN/ISBN: 0041-8781 PMID: 7330559 Document Number: 509
Gastrointestinal protein loss was assessed by a radioisotopic method in 16 patients with paracoccidioidomycosis. 51Cr albumin fecal excretion was higher in 10 patients with the lymphatic form of the disease (median = 2.50%) than in 6 cases with pulmonary and mucous lesions (median = 1.07%), and there was no difference between this group and 9 controls (median = 1.18%). Most of the patients with lymphatic lesions showed clinical or radiological signs of intestinal involvement. Lower levels of serum albumin and circulating lymphocytes were present in the patients with lymphatic form as compared to the pulmonary mucous group. Urinary excretion of D-xylose was similar in both groups. Hypoalbuminemia, lymphopenia, peripheral edema and chylous ascites were found in 2 patients with the lymphatic form who exhibited the highest fecal excretions of radioactivity following i.v. 51Cr albumin injection (9.43% and 11.16%). These cases are briefly reported. Fecal radioactivity excretion showed a highly significant negative correlation with serum albumin concentration and with circulating lymphocytes. There was also a highly significant positive correlation between fecal radioactivity excretion and fecal fat loss. Possible causative mechanisms of protein-losing enteropathy in paracoccidioidomycosis are discussed, as well as the related pathophysiologic features and the relevance of the present findings.
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