Protein-Losing Enteropathy
To the Editor: The review of protein-losing enteropathy (PLE) by Ozen and Lenardo (Aug. 24 issue) 1 provides a vivid depiction of the two principal pathologic mechanisms — namely, intestinal mucosa damage and microcirculation drainage failure (Fig. 2 of their article). The list of potential causes,...
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| Veröffentlicht in: | The New England journal of medicine 2023-11, Vol.389 (19), p.1825-1826 |
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| container_title | The New England journal of medicine |
| container_volume | 389 |
| creator | Redelmeier, Donald A. Patel, Akash M. Ozen, Ahmet Lenardo, Michael J. |
| description | To the Editor:
The review of protein-losing enteropathy (PLE) by Ozen and Lenardo (Aug. 24 issue)
1
provides a vivid depiction of the two principal pathologic mechanisms — namely, intestinal mucosa damage and microcirculation drainage failure (Fig. 2 of their article). The list of potential causes, however, seems to neglect a common condition. Specifically, major surgery involves intraoperative stresses that divert blood from the enteric circulation.
2
The decreased perfusion can lead to mucosal ischemia, reduced cellular integrity, and abnormal physiological characteristics (e.g., postoperative lactose intolerance).
3
In addition, postoperative atelectasis may indirectly impair microcirculation and lymphatic drainage.
4,5
Major surgery, therefore, could provoke . . . |
| doi_str_mv | 10.1056/NEJMc2311038 |
| format | Article |
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The review of protein-losing enteropathy (PLE) by Ozen and Lenardo (Aug. 24 issue)
1
provides a vivid depiction of the two principal pathologic mechanisms — namely, intestinal mucosa damage and microcirculation drainage failure (Fig. 2 of their article). The list of potential causes, however, seems to neglect a common condition. Specifically, major surgery involves intraoperative stresses that divert blood from the enteric circulation.
2
The decreased perfusion can lead to mucosal ischemia, reduced cellular integrity, and abnormal physiological characteristics (e.g., postoperative lactose intolerance).
3
In addition, postoperative atelectasis may indirectly impair microcirculation and lymphatic drainage.
4,5
Major surgery, therefore, could provoke . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMc2311038</identifier><language>eng</language><publisher>Boston: Massachusetts Medical Society</publisher><subject>Atelectasis ; Conflicts of interest ; Hypotheses ; Ischemia ; Lactose ; Lymphatic drainage ; Permeability ; Physiology ; Proteins ; Surgery ; Surgical drains ; Thrombosis</subject><ispartof>The New England journal of medicine, 2023-11, Vol.389 (19), p.1825-1826</ispartof><rights>Copyright © 2023 Massachusetts Medical Society. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c282t-359d9507cce87ccaef99a1354d40c38a6fa1e84b9baba31bef3c59324c3f8cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMc2311038$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.nejm.org/doi/full/10.1056/NEJMc2311038$$EHTML$$P50$$Gmms$$H</linktohtml><link.rule.ids>314,776,780,2746,2747,26080,27901,27902,52357,54039</link.rule.ids></links><search><creatorcontrib>Redelmeier, Donald A.</creatorcontrib><creatorcontrib>Patel, Akash M.</creatorcontrib><creatorcontrib>Ozen, Ahmet</creatorcontrib><creatorcontrib>Lenardo, Michael J.</creatorcontrib><title>Protein-Losing Enteropathy</title><title>The New England journal of medicine</title><description>To the Editor:
The review of protein-losing enteropathy (PLE) by Ozen and Lenardo (Aug. 24 issue)
1
provides a vivid depiction of the two principal pathologic mechanisms — namely, intestinal mucosa damage and microcirculation drainage failure (Fig. 2 of their article). The list of potential causes, however, seems to neglect a common condition. Specifically, major surgery involves intraoperative stresses that divert blood from the enteric circulation.
2
The decreased perfusion can lead to mucosal ischemia, reduced cellular integrity, and abnormal physiological characteristics (e.g., postoperative lactose intolerance).
3
In addition, postoperative atelectasis may indirectly impair microcirculation and lymphatic drainage.
4,5
Major surgery, therefore, could provoke . . .</description><subject>Atelectasis</subject><subject>Conflicts of interest</subject><subject>Hypotheses</subject><subject>Ischemia</subject><subject>Lactose</subject><subject>Lymphatic drainage</subject><subject>Permeability</subject><subject>Physiology</subject><subject>Proteins</subject><subject>Surgery</subject><subject>Surgical drains</subject><subject>Thrombosis</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpt0D1PwzAQBmALgUQobExMSDAwYLB9dmKPqApfCh9Dd8txHUiUxMVOhv57UoUBIW64Wx69Or0InVJyQ4lIb1_z5xfLgFICcg8lVABgzkm6jxJCmMQ8U3CIjmJsyDSUqwSdvQc_uLrHhY91_3Ge94MLfmOGz-0xOqhMG93Jz12g1X2-Wj7i4u3haXlXYMskGzAItVaCZNY6OS3jKqUMBcHXnFiQJq0MdZKXqjSlAVq6CqxQwLiFStoSFuhqjt0E_zW6OOiujta1remdH6NmUmY8E0qRiV78oY0fQz89t1OKMM6AT-p6Vjb4GIOr9CbUnQlbTYne9aR_9zTxy5l3XdS9a7r_2Teq22PD</recordid><startdate>20231109</startdate><enddate>20231109</enddate><creator>Redelmeier, Donald A.</creator><creator>Patel, Akash M.</creator><creator>Ozen, Ahmet</creator><creator>Lenardo, Michael J.</creator><general>Massachusetts Medical Society</general><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20231109</creationdate><title>Protein-Losing Enteropathy</title><author>Redelmeier, Donald A. ; Patel, Akash M. ; Ozen, Ahmet ; Lenardo, Michael J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c282t-359d9507cce87ccaef99a1354d40c38a6fa1e84b9baba31bef3c59324c3f8cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Atelectasis</topic><topic>Conflicts of interest</topic><topic>Hypotheses</topic><topic>Ischemia</topic><topic>Lactose</topic><topic>Lymphatic drainage</topic><topic>Permeability</topic><topic>Physiology</topic><topic>Proteins</topic><topic>Surgery</topic><topic>Surgical drains</topic><topic>Thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Redelmeier, Donald A.</creatorcontrib><creatorcontrib>Patel, Akash M.</creatorcontrib><creatorcontrib>Ozen, Ahmet</creatorcontrib><creatorcontrib>Lenardo, Michael J.</creatorcontrib><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Redelmeier, Donald A.</au><au>Patel, Akash M.</au><au>Ozen, Ahmet</au><au>Lenardo, Michael J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Protein-Losing Enteropathy</atitle><jtitle>The New England journal of medicine</jtitle><date>2023-11-09</date><risdate>2023</risdate><volume>389</volume><issue>19</issue><spage>1825</spage><epage>1826</epage><pages>1825-1826</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>To the Editor:
The review of protein-losing enteropathy (PLE) by Ozen and Lenardo (Aug. 24 issue)
1
provides a vivid depiction of the two principal pathologic mechanisms — namely, intestinal mucosa damage and microcirculation drainage failure (Fig. 2 of their article). The list of potential causes, however, seems to neglect a common condition. Specifically, major surgery involves intraoperative stresses that divert blood from the enteric circulation.
2
The decreased perfusion can lead to mucosal ischemia, reduced cellular integrity, and abnormal physiological characteristics (e.g., postoperative lactose intolerance).
3
In addition, postoperative atelectasis may indirectly impair microcirculation and lymphatic drainage.
4,5
Major surgery, therefore, could provoke . . .</abstract><cop>Boston</cop><pub>Massachusetts Medical Society</pub><doi>10.1056/NEJMc2311038</doi><tpages>2</tpages></addata></record> |
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| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2023-11, Vol.389 (19), p.1825-1826 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; New England Journal of Medicine |
| subjects | Atelectasis Conflicts of interest Hypotheses Ischemia Lactose Lymphatic drainage Permeability Physiology Proteins Surgery Surgical drains Thrombosis |
| title | Protein-Losing Enteropathy |
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