Elderly Onset Primary Intestinal Lymphangiectasia—A Rare Case

ABSTRACT Primary intestinal lymphangiectasia (PIL) is a rare protein‐losing gastroenteropathy characterized by diffuse or localized ectasia of the enteric lymphatics, which can be accompanied by lymphatic abnormalities in other parts of the body. This condition results in hypoalbuminemia, hypogammag...

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Main Authors: Li‐Han Goh, Madhavan Manoharan, Khean‐Lee Goh
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:JGH Open
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Online Access:https://doi.org/10.1002/jgh3.70102
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author Li‐Han Goh
Madhavan Manoharan
Khean‐Lee Goh
author_facet Li‐Han Goh
Madhavan Manoharan
Khean‐Lee Goh
author_sort Li‐Han Goh
collection DOAJ
description ABSTRACT Primary intestinal lymphangiectasia (PIL) is a rare protein‐losing gastroenteropathy characterized by diffuse or localized ectasia of the enteric lymphatics, which can be accompanied by lymphatic abnormalities in other parts of the body. This condition results in hypoalbuminemia, hypogammaglobulinemia, and lymphopenia due to the abnormal leakage of lymphatic fluid into the gastrointestinal tract. As there are no specific serological or radiological tests available, the gold standard for diagnosing intestinal lymphangiectasia is endoscopic examination with histopathological examination of intestinal biopsy specimens. We present a rare case of primary intestinal lymphangiectasia in a 62‐year‐old Chinese woman who presented with a six‐month history of lethargy, persistent diarrhea, and progressive weight loss. Gastroscopy and colonoscopy were performed, and biopsies revealed dilated intestinal lymphatics with broadened villi in the small intestine. Secondary causes of intestinal lymphangiectasia were ruled out, confirming the diagnosis of PIL. The patient was treated with a high‐protein, low‐fat diet supplemented with medium‐chain triglycerides, resulting in significant clinical improvement.
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spelling doaj-art-7e4ba7f9fa3f4c63824c74c2073aa51e2025-01-28T09:24:32ZengWileyJGH Open2397-90702025-01-0191n/an/a10.1002/jgh3.70102Elderly Onset Primary Intestinal Lymphangiectasia—A Rare CaseLi‐Han Goh0Madhavan Manoharan1Khean‐Lee Goh2Faculty of Medicine, St Vincent's Clinical School The University of New South Wales Sydney New South Wales AustraliaInnoquest Pathology Sdn Bhd Petaling Jaya MalaysiaFaculty of Medicine University of Malaya Kuala Lumpur MalaysiaABSTRACT Primary intestinal lymphangiectasia (PIL) is a rare protein‐losing gastroenteropathy characterized by diffuse or localized ectasia of the enteric lymphatics, which can be accompanied by lymphatic abnormalities in other parts of the body. This condition results in hypoalbuminemia, hypogammaglobulinemia, and lymphopenia due to the abnormal leakage of lymphatic fluid into the gastrointestinal tract. As there are no specific serological or radiological tests available, the gold standard for diagnosing intestinal lymphangiectasia is endoscopic examination with histopathological examination of intestinal biopsy specimens. We present a rare case of primary intestinal lymphangiectasia in a 62‐year‐old Chinese woman who presented with a six‐month history of lethargy, persistent diarrhea, and progressive weight loss. Gastroscopy and colonoscopy were performed, and biopsies revealed dilated intestinal lymphatics with broadened villi in the small intestine. Secondary causes of intestinal lymphangiectasia were ruled out, confirming the diagnosis of PIL. The patient was treated with a high‐protein, low‐fat diet supplemented with medium‐chain triglycerides, resulting in significant clinical improvement.https://doi.org/10.1002/jgh3.70102endoscopyprimary intestinal lymphangiectasiaprotein losing enteropathy
spellingShingle Li‐Han Goh
Madhavan Manoharan
Khean‐Lee Goh
Elderly Onset Primary Intestinal Lymphangiectasia—A Rare Case
JGH Open
endoscopy
primary intestinal lymphangiectasia
protein losing enteropathy
title Elderly Onset Primary Intestinal Lymphangiectasia—A Rare Case
title_full Elderly Onset Primary Intestinal Lymphangiectasia—A Rare Case
title_fullStr Elderly Onset Primary Intestinal Lymphangiectasia—A Rare Case
title_full_unstemmed Elderly Onset Primary Intestinal Lymphangiectasia—A Rare Case
title_short Elderly Onset Primary Intestinal Lymphangiectasia—A Rare Case
title_sort elderly onset primary intestinal lymphangiectasia a rare case
topic endoscopy
primary intestinal lymphangiectasia
protein losing enteropathy
url https://doi.org/10.1002/jgh3.70102
work_keys_str_mv AT lihangoh elderlyonsetprimaryintestinallymphangiectasiaararecase
AT madhavanmanoharan elderlyonsetprimaryintestinallymphangiectasiaararecase
AT kheanleegoh elderlyonsetprimaryintestinallymphangiectasiaararecase