# Cytomegalovirus Enteritis: A Rare Culprit of Protein Losing Enteropathy in an Immunocompetent Adult

## TL;DR

A 60-year-old healthy woman developed a rare condition called protein-losing enteropathy due to a cytomegalovirus infection, which was successfully treated with valganciclovir.

## Contribution

This case report highlights CMV enteritis as a rare cause of PLE in immunocompetent adults.

## Key findings

- The patient had low serum protein and increased fecal alpha-1 antitrypsin, confirming PLE.
- CMV-specific immunohistochemistry confirmed CMV enteritis as the cause of PLE.
- Treatment with valganciclovir resolved symptoms and normalized endoscopic findings.

## Abstract

Protein-losing enteropathy (PLE) is a rare complication of cytomegalovirus (CMV) enteritis in immunocompetent individuals. We present a case of a previously healthy 60-year-old woman with an acute CMV infection, manifesting as intractable vomiting and diarrhea, refractory electrolyte disturbances, and anasarca. The diagnostic evaluation showed low serum protein levels and an increased fecal alpha-1 antitrypsin clearance, confirming PLE. CMV-specific immunohistochemistry on duodenal samples subsequently confirmed that the PLE was caused by CMV enteritis. She completed treatment with valganciclovir for 3 weeks, resulting in symptom resolution and normalization of endoscopic findings. This case highlights the importance of recognizing CMV-associated PLE, particularly in immunocompetent individuals, for timely diagnosis and treatment.