Hypoproteinaemia and Hypoalbuminemia- think outside the Liver

Background and Aim: An altered liver function test does not always indicate pathology in the liver. We present a case of chronic diarrhea referred for an test. This underscores importance considering apart from cases with low albumin protein levels. Case report: A 65-year-old female K/C/O hypertension hypothyroidism on oral medications presented persistent small bowel type vomiting, initially treated elsewhere as acute gastroenteritis IV antibiotics hydration view diarrhoea LFT. In blood investigations, patient was found to have hypoproteinaemia hypoalbuminemia raised CRP. diarrhoea, differentials malabsorptive Clostridium difficle were considered. The underwent OGD, which suggestive hiatus hernia, reflux esophagitis, antral duodenal erosions, HPE showing gastritis. colonoscopy showed edematous colonic mucosa, biopsy non-specific inflammation. stool difficile toxins B GDH negative. CECT abdomen done, normal. After careful review medications, be Tab. Olmesartan hypertension; biopsies critically reviewed, she villous atrophy. Considering patient’s clinical presentation, medication history, absence other identifiable causes, diagnosis olmesartan-induced enteropathy made, antihypertensive modified accordingly. followed up is symptomatically better. Conclusion: Comprehensive evaluation crucial hypoproteinemia identify underlying causes outside liver, reviewing also helps timely recognition management pathology.