Protein-losing enteropathy caused by mesenteric venous thrombosis with protein C deficiency

A 63-year-old man presented with leg edema and hypoproteinemia. His alpha-1 antitrypsin clearance rate of 174 mL/day indicated the presence of protein -losing enteropathy (PLE). Computed tomographic scans demonstrated thickene d ileal wall and mesenteric edema. Angiography revealed occlusion in a peri pheral branch of the superior mesenteric vein. Furthermore, both the patien t and his son had low protein C levels. The patient was treated successfull y with partial resection of the ileum. Histologic examination of the resect ed ileum revealed multiple erosions and submucosal fibrosis with organized venous thrombi in the mesenteric veins. This is the first case report of PL E caused by mesenteric venous thrombosis, and our findings suggest that ser um protein was lost through erosion of the ileum caused by ischemia due to mesenteric venous thrombosis.