A case of protein-losing enteropathy improved by endoscopic resection of inflammatory polyps in a patient with ulcerative colitis in remission

Hypoalbuminemia is rare during remission of ulcerative colitis (UC). We report a 22-year-old man with extensive UC in clinical and endoscopic remission under infliximab treatment who developed hypoalbuminemia (minimum 1.4 g/dl). Colonoscopy revealed multiple pedunculated inflammatory polyps. Protein-losing scintigraphy indicated protein leakage from the colon. Endoscopic resection and ischemic clipping of polyps were performed, resulting in marked improvement in serum albumin. Histology confirmed inflammatory polyps. Previous UC cases with protein-losing enteropathy due to inflammatory polyposis have required surgery. This is the first reported case successfully treated endoscopically. Inflammatory polyps can cause hypoalbuminemia even during remission, and endoscopic removal may be a viable treatment.