{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T01:05:09Z","timestamp":1778893509435,"version":"3.51.4"},"reference-count":6,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>Rare yet significant, this case sheds light on the uncommon presentation of Waldmann's disease in adults, showcasing the diagnostic challenges it poses. A multidisciplinary approach, integrating clinical, endoscopic, histological, and radiological evaluations, is crucial for accurate diagnosis and management. Further research is needed to deepen our understanding of this complex disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Waldmann's disease, or primary intestinal lymphangiectasia, is a rare disorder characterized by protein\u2010losing enteropathy due to dilation and leakage of intestinal lymphatic vessels. Although typically diagnosed in early childhood, we present a case of a 55\u2010year\u2010old male with a complex medical history. The patient's history included intestinal obstruction, multidrug\u2010resistant pulmonary tuberculosis, and primary antiphospholipid syndrome. He presented with a 2\u2010year history of chronic diarrhea, weight loss, and lower limb edema. Endoscopic and histological examination revealed scattered white spots in the duodenum and terminal ileum, indicative of intestinal lymphangiectasia. Nuclear medicine studies confirmed abnormal protein loss. The rarity of Waldmann's disease in adulthood and its association with other significant medical conditions pose diagnostic challenges. The distinct endoscopic and histological findings, coupled with scintigraphy results, contribute to a comprehensive understanding of this complex case. Differential diagnoses and management considerations are discussed. This case highlights the atypical presentation of Waldmann's disease in adulthood, emphasizing the importance of a multidisciplinary approach for accurate diagnosis and management. Further research is warranted to enhance our understanding of this uncommon disorder and its potential implications for patients with complex medical histories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccr3.8772","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T07:30:34Z","timestamp":1713339034000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Waldmann's disease: Primary intestinal lymphangiectasia diagnosed by 99mTc\u2010labeled albumin macroaggregate scintigraphy\u2014A case report in an adult patient"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2409-6613","authenticated-orcid":false,"given":"Alex Jos\u00e9","family":"Castell\u00f3n\u00a0M\u00e9ndez","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Manolo Morales Peralta Hospital  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8581-4727","authenticated-orcid":false,"given":"Allan","family":"Bod\u00e1n\u00a0Campbell","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Manolo Morales Peralta Hospital  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1748-1651","authenticated-orcid":false,"given":"Victor","family":"Rosales\u00a0Obreg\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Nora Astorga National Radiotherapy Center  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9526-6812","authenticated-orcid":false,"given":"Mohammed","family":"Zahran","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Manolo Morales Peralta Hospital  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i48.7707"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2301594"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S136803"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000327914"},{"issue":"4","key":"e_1_2_11_6_1","first-page":"413","article-title":"Diagnostic accuracy of nuclear medicine imaging in protein losing enteropathy: systematic review and meta\u2010analysis of the literature","volume":"76","author":"Khalesi M","year":"2013","journal-title":"Acta Gastroenterol Belg"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","unstructured":"MartinsC GagnaireA RostainF LepageC.Waldmann's disease: a rare cause of protein losing enteropathy in an adult patient.2017;109(5):385\u2010388.","DOI":"10.17235\/reed.2017.4593\/2016"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:27:20Z","timestamp":1764253640000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/ccr3.8772"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8772","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2024-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8772"}}