PLE stands for protein losing enteropathy and was the subject of a review article in a recent issue of The New England Journal of Medicine. PLE is a syndrome not a specific disease and can occur for a wide variety of reasons.  The problem is caused by the loss of plasma proteins through the intestines (they “leak” out).  In general terms it is caused by illnesses that damage the intestinal lining or that block the intestinal lymphatic drainage.

The resultant loss of proteins causes a drop in oncotic pressure which lead to edema. The loss of immune proteins causes a greater predilection to infections.  The most common cause for PLE is inflammatory bowel disease such as regional enteritis or Crohn’s disease.  But for our purposes, food allergy, eosinophilic enteritis, and gluten sensitivity are all potential causes.  All three of these conditions can cause inflammation in the GI tract and if its is severe enough to cause disruption of the GI tract mucosa and PLE.  Clues to this possibility include “GI tumult”, edema in the ankles/legs, and a low albumin and/or globulin on blood work.  Correcting the cause of inflammation fixes the PLE.