Oral Budesonide as a Therapy for Protein-Losing Enteropathy in Children After the Fontan Operation

Background and Aim Protein‐losing enteropathy is a rare complication of the Fontan palliation surgery. Budesonide is an effective treatment option for protein‐losing enteropathy. We reviewed our retrospective experience in four patients who were treated with oral budesonide. Methods Four patients with refractory protein‐losing enteropathy after the Fontan operation were started on oral budesonide 9 mg/daily. After achieving normal serum albumin the dose was tapered to 3 mg. Response to oral budesonide, side effects, and serum albumin levels before the treatment and at first, fourth, and ninth months of the budesonide course were recorded. Efficacy was measured based on serum albumin levels and clinical symptoms. Results Mean pretherapy albumin was 2.25 g/dL (range 1.7 to 2.5 g/dL) and nine months after therapy it was 4.15 g/dL (range 3.9 to 4.4 g/dL) (p