What is the direct clinical consequence of protein-rich lymph leaking into the gut lumen in lymphangiectasia?

• A. Protein-losing enteropathy
• B. Diarrhea without protein loss
• C. Hemorrhagic gastritis
• D. Intestinal obstruction

Answer: (A)

When intestinal lymphatics become dilated and leak lymph into the gut lumen, the fluid that pours into the intestine is rich in plasma proteins, especially albumin. The direct result of this leakage is protein-losing enteropathy, meaning a loss of circulating proteins into the intestinal tract. This leads to hypoalbuminemia and potential immune compromise from loss of immunoglobulins, along with edema from reduced plasma oncotic pressure.

This isn’t simply more stool or diarrhea; it’s ongoing loss of protein through the gut. Hemorrhagic gastritis would involve bleeding in the stomach, not protein loss via the lymphatics of the intestine, and intestinal obstruction is a blockage—not a leakage problem.