Protein-losing enteropathy in systemic lupus erythematosus: three cases and review of the literature.

Protein-losing enteropathy (PLE) is characterized by loss of essentially pr otein substances into the gastrointestinal tract. Few reports of PLE superv ening in patients who have systemic lupus erythematosus (SLE) have appeared in the literature, We report three new cases, All three were women who had a severe form of SLE involving several organs, PLE was diagnosed on the ba sis of an increased clearance of al antitrypsin. The severeness of the clin ical picture in all three patients justified the use of immunosuppressive a gents (corticosteroids and pulse cyclophosphamide therapy) which were effec tive, These cases are compared to the 24 previously reported. The frequency of PLE during an SLE flare-up is probably underestimated,It should be look ed for in SLE patients who have edema by means of the simple alpha 1 antitr ypsin test. PLE is often found in severe clinical forms of SLE and should b e managed using corticosteroids either alone or in association with immunos uppressive drugs.