Use of heparin in the treatment of protein-losing enteropathy after fontan operation for complex congenital heart disease

Mayo Clin Proc. 1998 Aug;73(8):777-9. doi: 10.4065/73.8.777.

Abstract

Protein-losing enteropathy (PLE) is a serious complication of the Fontan operation and is associated with pronounced mortality. Medical management of PLE has been only partially successful. A recent report noted dramatic improvement in patients with PLE within 3 weeks of subcutaneous administration of heparin. We report a case of reversal of PLE with resolution of clinical symptoms and normalization of serum albumin, total protein, and fecal alpha1-antitrypsin values after several months of heparin treatment. Our findings substantiate those recently reported but suggest that reversal of PLE may necessitate more than a few weeks of heparin therapy.

Publication types

  • Case Reports

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Blood Proteins / drug effects*
  • Blood Proteins / metabolism
  • Fontan Procedure / adverse effects*
  • Heart Defects, Congenital / surgery*
  • Heparin / administration & dosage
  • Heparin / therapeutic use*
  • Humans
  • Male
  • Protein-Losing Enteropathies / drug therapy*
  • Protein-Losing Enteropathies / etiology
  • Protein-Losing Enteropathies / metabolism
  • Serum Albumin / drug effects
  • alpha 1-Antitrypsin / drug effects*
  • alpha 1-Antitrypsin / metabolism

Substances

  • Blood Proteins
  • Serum Albumin
  • alpha 1-Antitrypsin
  • Heparin