Intestinal lymphangiectasia and reversible high liver stiffness

Primary intestinal lymphangiectasia (PIL) is a protein-losing enteropathy characterized by tortuous and dilated lymph channels of the small bowel. The main symptoms are bilateral lower limb edema, serosal effusions, vitamin D malabsorption resulting in osteoporosis. We reported here a case of long-lasting misdiagnosed PIL with a peculiar liver picture, characterized by very high stiffness value at transient elastography, which decreased with clinical improvement. The complex interplay between lymphatic and hepatic circulatory system was discussed