A rare cause of peripheral edema: exudative lymphocytic gastritis induced hypoprotidemia

A rare cause of peripheral edema: exudative lymphocytic gastritis induced hypoprotidemia

Nephrol Ther. 2007 Jun

Montagnac R, Blaison D, Ciupea A, Für A, Pradel J, Schillinger F.
Service de néphrologie–hémodialyse, centre hospitalier de Troyes, 10003 Troyes cedex, France.

Diagnosis of edema secondary to hypoprotidemia but without nutritional, renal, hepatic or cardiac cause, must consider exsudative digestive disease, of which the lymphocytic gastritis, as the authors report here a new observation diagnosed in a 73 year-old woman. Gastroscopy reveals varioliform gastritis and biopsy demonstrates diffuse infiltration of the gastric epithelium by lymphocytes, making of it a real histopathologic entity among the gastropathies.

Etiology and pathogeny remain still unknown but proton pump gastric inhibitors are an effective treatment.

PMID: 17540312 [PubMed - as supplied by publisher]

Edematous syndrome revealing an exudative lymphocytic gastritis: efficacy of omeprazole

[Article in French]
Cacoub P, Sbaï A, Costedoat-Chalumeau N, Bellanger J, Godeau P, Piette JC.Service de Médecine Interne, Hôpital de la Pitié-Salpêtrière, Paris. patrice.cacoub@psl.ap-hop-paris.fr

Lymphocytic gastritis is characterized by intense lymphocytic infiltration of gastric epithelium. Excessive gastric protein loss is uncommon. We describe the case of a 49-year-old white woman suffering from generalized edema and abdominal pain. She had severe serum hypoproteinemia, hypoalbuminemia and hypogammaglobulinemia. There was no renal, cardiac or hepatic origin of protein loss, and no protein-losing enteropathy. Endoscopic examination showed diffuse varioliform gastritis and histology confirmed lymphocytic gastritis with > 30% intraepithelial lymphocytes without Helicobacter pylori. The protein loss stopped within two weeks of the beginning of omeprazole and extensive edema disappeared. Four years later, the patient was still free from edema.

Inflammatory involvement of the gastric mucosa probably caused protein losing in this patient.

Recognition of this exsudative gastropathy is important because long term remission is obtained with omeprazole.

Masson