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

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.