Classification of intestinal lymphangiectasia with protein-losing enteropathy

White villi type and non-white villi type

Naoki Omiya, Masanao Nakamura, Takeshi Yamamura, Koji Yamada, Asuka Nagura, Toru Yoshimura, Yoshiki Hirooka, Ichiro Hirata, Hidemi Goto

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background/Aims: We classified intestinal lymphangiectasia (IL) into two categories, the white and non-white villi types, and evaluated their clinical characteristics and therapeutic responses. Methods: Of the 988 patients who underwent double-balloon enteroscopy, 14 consecutive patients (7 men and 7 women, median age at onset 34 years) were enrolled with immunohistochemically confirmed IL with protein-losing enteropathy. Results: Enteroscopically the white villi type (n = 8) showed white plaques and white-tipped villi were scattered in the small bowel, while non-white villi type (n = 6) showed that apparently normal but under more detailed observation, low and round villi with a normal color were diffused. The serum albumin levels and fecal α1-antitrypsin clearance before treatment were significantly worse in the non-white villi type (p = 0.017 and 0.039, respectively), whereas the serum immunoglobulin A and M levels were significantly lower in the white villi type (p = 0.010 and 0.046, respectively). At gastroscopy, a non-cirrhotic snakeskin appearance was significantly observed in the non-white villi type (p = 0.015). The corticosteroid response was better in the non-white villi type (p = 0.015). Conclusion: Two distinct subgroups were found in IL. This classification was useful in pathophysiological clustering and in predicting the therapeutic response.

Original languageEnglish
Pages (from-to)155-166
Number of pages12
JournalDigestion
Volume90
Issue number3
DOIs
Publication statusPublished - 25-12-2014

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Intestinal Lymphangiectasis
Protein-Losing Enteropathies
Double-Balloon Enteroscopy
Gastroscopy
Age of Onset
Serum Albumin
Immunoglobulin A
Immunoglobulin M
Cluster Analysis
Adrenal Cortex Hormones
Therapeutics
Color
Observation
Serum

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Omiya, Naoki ; Nakamura, Masanao ; Yamamura, Takeshi ; Yamada, Koji ; Nagura, Asuka ; Yoshimura, Toru ; Hirooka, Yoshiki ; Hirata, Ichiro ; Goto, Hidemi. / Classification of intestinal lymphangiectasia with protein-losing enteropathy : White villi type and non-white villi type. In: Digestion. 2014 ; Vol. 90, No. 3. pp. 155-166.
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abstract = "Background/Aims: We classified intestinal lymphangiectasia (IL) into two categories, the white and non-white villi types, and evaluated their clinical characteristics and therapeutic responses. Methods: Of the 988 patients who underwent double-balloon enteroscopy, 14 consecutive patients (7 men and 7 women, median age at onset 34 years) were enrolled with immunohistochemically confirmed IL with protein-losing enteropathy. Results: Enteroscopically the white villi type (n = 8) showed white plaques and white-tipped villi were scattered in the small bowel, while non-white villi type (n = 6) showed that apparently normal but under more detailed observation, low and round villi with a normal color were diffused. The serum albumin levels and fecal α1-antitrypsin clearance before treatment were significantly worse in the non-white villi type (p = 0.017 and 0.039, respectively), whereas the serum immunoglobulin A and M levels were significantly lower in the white villi type (p = 0.010 and 0.046, respectively). At gastroscopy, a non-cirrhotic snakeskin appearance was significantly observed in the non-white villi type (p = 0.015). The corticosteroid response was better in the non-white villi type (p = 0.015). Conclusion: Two distinct subgroups were found in IL. This classification was useful in pathophysiological clustering and in predicting the therapeutic response.",
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Omiya, N, Nakamura, M, Yamamura, T, Yamada, K, Nagura, A, Yoshimura, T, Hirooka, Y, Hirata, I & Goto, H 2014, 'Classification of intestinal lymphangiectasia with protein-losing enteropathy: White villi type and non-white villi type', Digestion, vol. 90, no. 3, pp. 155-166. https://doi.org/10.1159/000365987

Classification of intestinal lymphangiectasia with protein-losing enteropathy : White villi type and non-white villi type. / Omiya, Naoki; Nakamura, Masanao; Yamamura, Takeshi; Yamada, Koji; Nagura, Asuka; Yoshimura, Toru; Hirooka, Yoshiki; Hirata, Ichiro; Goto, Hidemi.

In: Digestion, Vol. 90, No. 3, 25.12.2014, p. 155-166.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Classification of intestinal lymphangiectasia with protein-losing enteropathy

T2 - White villi type and non-white villi type

AU - Omiya, Naoki

AU - Nakamura, Masanao

AU - Yamamura, Takeshi

AU - Yamada, Koji

AU - Nagura, Asuka

AU - Yoshimura, Toru

AU - Hirooka, Yoshiki

AU - Hirata, Ichiro

AU - Goto, Hidemi

PY - 2014/12/25

Y1 - 2014/12/25

N2 - Background/Aims: We classified intestinal lymphangiectasia (IL) into two categories, the white and non-white villi types, and evaluated their clinical characteristics and therapeutic responses. Methods: Of the 988 patients who underwent double-balloon enteroscopy, 14 consecutive patients (7 men and 7 women, median age at onset 34 years) were enrolled with immunohistochemically confirmed IL with protein-losing enteropathy. Results: Enteroscopically the white villi type (n = 8) showed white plaques and white-tipped villi were scattered in the small bowel, while non-white villi type (n = 6) showed that apparently normal but under more detailed observation, low and round villi with a normal color were diffused. The serum albumin levels and fecal α1-antitrypsin clearance before treatment were significantly worse in the non-white villi type (p = 0.017 and 0.039, respectively), whereas the serum immunoglobulin A and M levels were significantly lower in the white villi type (p = 0.010 and 0.046, respectively). At gastroscopy, a non-cirrhotic snakeskin appearance was significantly observed in the non-white villi type (p = 0.015). The corticosteroid response was better in the non-white villi type (p = 0.015). Conclusion: Two distinct subgroups were found in IL. This classification was useful in pathophysiological clustering and in predicting the therapeutic response.

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