case_images: PMC9207951_01
case_images: Cardiac computed tomography shows bilateral pleural effusion and a calcified pericardium (red arrows).
case_images: fped-10-875032-g0001.jpg
case_images: PMC9207951_01_fped-10-875032-g0001.jpg
case_images: F1
case_images: Cardiac CT showed a calcified pericardium (Figure 1).
case_images: Ultrasonography shows decreased cardiac function underlying protein-losing enteropathy. (A) M-mode ultrasonography shows thickening of the posterior pericardium of the posterior wall of the left ventricle and signs of a septal notch. The left ventricular ejection fraction is 77%. (B) The posterior pericardium of the posterior wall of the left ventricle is thickened (thickness, 7 mm). (C) Pulse Doppler shows limited ventricular diastolic activity. The high peak E and low peak A result in an E/A of >2. (D) A four-chamber view of the heart shows marked thickening of the pericardium and atrial enlargement. (E) The inferior vena cava is greatly widened (width, 26 mm). (F) Myocardial relaxation is normal.
case_images: fped-10-875032-g0002.jpg
case_images: PMC9207951_01_fped-10-875032-g0002.jpg
case_images: F2
case_images: Echocardiography showed decreased cardiac function underlying protein-losing enteropathy (PLE; Figure 2).
case_images: Anterior plane abdominal scintigraphy at 10 min and 1, 2, 3, 6, and 24 h after intravenous administration of technetium-99m-labeled human serum albumin. Tracer accumulation in large vessels, heart blood pool, liver, and kidney is present at 10 min and 1 h. Tracer accumulation in the abdomen is not present at 10 min and 1 h. Tracer accumulation in the lower abdomen is vaguely observed at 2 and 3 h (red circles). A large amount of tracer accumulation is present in the right lower abdomen at 6 h, and the radionuclide shows the bowel. Clear colonic tracer accumulation is present at 24 h.
case_images: fped-10-875032-g0003.jpg
case_images: PMC9207951_01_fped-10-875032-g0003.jpg
case_images: F3
case_images: Functional imaging with technetium-99m serum albumin identified the region of protein leakage as the intestine (Figure 3).
case_images: Pathological examination of the pericardium shows hyaline degeneration (red arrow).
case_images: fped-10-875032-g0004.jpg
case_images: PMC9207951_01_fped-10-875032-g0004.jpg
case_images: F4
case_images: A pathological examination of the pericardium showed hyaline degeneration (Figure 4).
case_images: Clinical course of the patient. Serum albumin concentrations are improved after pericardiectomy.
case_images: fped-10-875032-g0005.jpg
case_images: PMC9207951_01_fped-10-875032-g0005.jpg
case_images: F5
case_images: His serum albumin concentrations were increased (3.3-3.7 g/dL), which indicated resolution of the PLE (Figure 5).