Protein Losing Entropathy after Post Operative Cardiac Surgery in Children

Abstract

Protein losing entropathy is characterized by more loss of proteins via GIT than synthesis leading to hypoalbumenemia it is not single disease but an atypical manifestation of other diseases. The most common presenting symptom is edema of the legs an other areas secondary to decreased plasma oncotic pressure with subsequent Transudation of fluid from the capillary bed to subcutaneous tissue. This study was carried to detect frequency of protein losing entropathy children with CHDs who presented to PED.CCU. In Atfal Misr hospital they were diagnosed in out patient clinic of cardiology between 2012_2013 the study include 30 patient 19 male and 11female between age of 5 month and 2 years. All patient have undergone medical history taking with especial emphasis of analysis of patient of CHDs. As (cyanosis- tachycardia - tachypnea - clubbing of finger - failure to thrive-recurent chest infection). Associated chest manifestation (cough-respiratory distress - recurent chest infection). Associated systemic manifestation (dyspepsia- abdominal pain- LL odema). Associated infective indocarditis manifestation (fever-RD-Low cardiac out put). Associated abdominal manifestation (abd. Distention-vomiting - diarrhea- upper and lower GI bleeding. Dietitic history (milk feeding-age of weaning - age of introduction of artificial milk). Patient have undergone careful clinical examination with especial emphasis on: Vital signs (puls-RR- temp) and (pallor-cyanosis-jaundice) wt and height. Cardiac examination (cyanosis observe tongue for c.cyanosis -RD - pricordial pulge). Abdominal exam. (superficial tenderness-hepatomegaly- splenomegaly) extensive diagnostic work up was done according to clinical data and include detailed laboratory investigation (fecal alpha one antitrypsin-CBC-S.albumin-T protein) to diagnos PLE which in pts with positive fecal alpha-1 antitrypsin and decrease in serum albumin and total protein.