Elusive Edematous Primary Intestinal Lymphangiectasia in an Adult Patient Presenting With New Onset of Protein-Losing Enteropathy

Primary intestinal lymphangiectasia is a rare disorder characterized by the dilation of lymphatic vessels in the small intestine, resulting in the loss of proteins, particularly albumin, into the gastrointestinal tract which leads to a protein-losing enteropathy. We report the case of a 66-year-old African American man who presented with insidious abdominal pain, chronic diarrhea, hypoalbuminemia, leukopenia, and anemia. An elusive diagnosis of edematous subtype primary intestinal lymphangiectasia with protein-losing enteropathy was confirmed through a multimodal diagnostic approach, including video capsule endoscopy and small bowel endoscopy with biopsies. Treatment was focused on optimizing the patient's nutritional status.