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THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2023 | VOLUME 21 | ISSUE 1 | 17 20. Levitt DG, Levitt MD. Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states. Clin Exp Gastroenterol. 2017; 10:147–168. 21. Al-Mogairen SM. Lupus protein-losing enteropa- thy (LUPLE): a systematic review. Rheumatol Int. 2011;31:995–1001. 22. Bernier JJ, Florent C, Desmazures C, et al. Diagno- sis of protein-losing enteropathy by gastrointestinal clearance of alpha1-antitrypsin. Lancet (London, England) 1978; 2:763–764 23. Takeda H, Nishise S, Furukawa M et al. Fecal clearance of 1-antitrypsin with lansoprazole can detect protein-losing gastropathy. Dig Dis Sci. 1999; 44(11):2313–2318 24. Fritscher-Ravens A, Scherbakov P, Bufler P et al. The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicentre European study. Gut. 2009; 58:1467–1472 25. Luca Elli, Matilde Topa, and Alessandro Rimondi. Protein-losing enteropathy. Curr Opin Gastroenterol. 2020; 36(3):238–244 26. Alpers DH, Stenson WF, Bier DM. Nutritional planning for patients with protein and calorie deficiency. In: Alpers DH (ed) Manual of nutritional therapeutics, 3rd edn. Brown, Boston. 1995; p 265 27. Lin, W., Hwang, M., Chung, H., Chu, J., Lai, M., Yang, J.et al. Protein-losing enteropathy after the Fontan operation: clinical analysis of nine cases. Chang Gung medical journal. 2006; 29(5), 505. Tables and figures Fig. 1. Decision tree for the exploration strategy of an exudative enteropathy. Fig. 2. Confocal endoscopy in a patient with duodenal lymphangiectasia: mucosa with rice-grain appearance (a) diffuse fluid with smoke-like appearance (b) CASE SERIES Visit our website www.ihpublishing.co.za GASTROENTEROLOGY South African Review