Elusive Edematous Primary Intestinal Lymphangiectasia in an Adult Patient Presenting With New Onset of Protein-Losing Enteropathy

Oscar Noble; Ramon O Minjares; Rebecca Yorke; Alberto Barroso

doi:10.14309/crj.0000000000001764

Elusive Edematous Primary Intestinal Lymphangiectasia in an Adult Patient Presenting With New Onset of Protein-Losing Enteropathy

ACG Case Rep J. 2025 Jul 7;12(7):e01764. doi: 10.14309/crj.0000000000001764. eCollection 2025 Jul.

Authors

Oscar Noble^{1

2}, Ramon O Minjares^{1

2}, Rebecca Yorke^{2

3}, Alberto Barroso^{1

2

4}

Affiliations

¹ Lynda K. and David M. Underwood Center for Digestive Disorders, Houston Methodist Hospital, Houston, TX.
² Houston Methodist Research Institute and Weil Cornell College of Medicine, Houston, TX.
³ Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX.
⁴ Texas A&M College of Medicine, Houston, TX.

Abstract

Primary intestinal lymphangiectasia is a rare disorder characterized by the dilation of lymphatic vessels in the small intestine, resulting in the loss of proteins, particularly albumin, into the gastrointestinal tract which leads to a protein-losing enteropathy. We report the case of a 66-year-old African American man who presented with insidious abdominal pain, chronic diarrhea, hypoalbuminemia, leukopenia, and anemia. An elusive diagnosis of edematous subtype primary intestinal lymphangiectasia with protein-losing enteropathy was confirmed through a multimodal diagnostic approach, including video capsule endoscopy and small bowel endoscopy with biopsies. Treatment was focused on optimizing the patient's nutritional status.

Keywords: enteropathy; hypoalbuminemia; lymphangiectasia.

Publication types

Case Reports