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This study was performed to assess how disorders of intestinal lymphatics affect the fat absorption and plasma fatty acid composition in patients with protein-losing enteropathy (PLE). Olive oil tolerance test, 131I-triolein test and jejunal endoscopy were carried out in patients with PLE. Patients with PLE were divided into two groups. Group A included diseases with disorders of intestinal lymphatics and group B included diseases without such disorders. Plasma lipids in patients with PLE at fasting showed similar abnormalities of fatty acid composition to that of malabsorption syndrome, especially in group A.Percentage increases of total concentration of plasma lipids and oleic acid fraction after olive oil administration were depressed in patients with PLE group A and malabsorption syndrome when compared with that of normal subjects and PLE group B. However there are patients with PLE group A who showed normal fecal excretion rate of 131I-triolein, despite the abnormal values of olive oil tolerance test. We observed the findings of white villi or scattered white spots by jejunal endoscopy in all patients with PLE group A. These results suggested that the abnormalities of intestinal lymphatics may play an important role in the impaired lipid absorption and the abnormal plasma fatty acid composition in patients with PLE and that a delayed transport of lipid from intestinal epithelial cells to lymphatics was existed in these patients.
財団法人日本消化器病学会の論文

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