Nephrotic Syndrome and Protein-Losing Enteropathy in A Patient with Suspected Systemic Lupus Erythematosus A Case Report

We report a 57-year-old female patient with suspected systemic lupus erythematosus presented with general anasarca, pleural effusions, hypercholesterolemia and severe hypoalbuminemia. First, nephrotic-range proteinuria was revealed and membranous glomerulonephritis was diagnosed and successfully treated. She developed diarrhea 2 years later with similar clinical presentations but this time no proteinuria was found. Primary protein-losing enteropthy, a rare complication of systemic lupus erythematosus, was diagnosed after other causes of gastrointestinal protein loss were excluded. Complete remission was achieved with steroid therapy. This case is unusual by the presentation of the same clinical pictures with different etiologies. Hypoalbuminemia and general anasarca need further investigation if renal protein loss was not found. ( J Intern Med Taiwan 2005; 16: 139-145 )