Protein-losing enteropathy with an endoscopic feature of 'the watermelon colon'

Young Tae Bak, Oh Sang Kwon, Jin Young Kim, Jae Seon Kim, Jin Ho Kim, Nam Hee Won

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


A watermelon lesion involving the gastrointestinal tract other than the stomach has not been reported previously except for two cases with rectal involvement and another case with caecal involvement. This report describes a case of protein-losing enteropathy with endoscopic features of 'the watermelon lesion' involving nearly the entire colon. A 57-year-old man presented with a six-month history of generalized oedema and diarrhoea. Laboratory findings included elevated erythrocyte sedimentation rate and decreased serum total protein and albumin. Serum fluorescent anti-nuclear antibody, anti-dsDNA antibody and anti-La antibody were positive. Upper gastrointestinal endoscopy was unremarkable. Colonoscopy showed seven or eight longitudinal reddish stripes along the entire length of the colon and rectum sparing the caecum. Biopsies from the duodenum and colon revealed mildly ectatic lymphatics in the submucosa. Colonic biopsy also exhibited some haemosiderin-laden macrophages in the muscularis mucosae and submucosa. 99mTc-human serum albumin scintigraphy demonstrated a leak into the intestinal lumen. Oral prednisolone therapy was started and his symptoms and signs gradually improved over months. Steroid could be withdrawn after 7 months of therapy, and the patient has remained free of symptoms for 1 year of follow-up after withdrawal of the steroid.

Original languageEnglish
Pages (from-to)565-567
Number of pages3
JournalEuropean Journal of Gastroenterology and Hepatology
Issue number5
Publication statusPublished - 1999
Externally publishedYes


  • Autoimmunity
  • Corticosteroid therapy
  • Protein-losing enteropathy
  • Watermelon colon

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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