[MENETRIER DISEASE]

Menetrier disease (MD) is a very rare stomach pathology of unknown etiology characterized by manifest hypertrophy of gastric mucosa. The main causes of MD are believed to be Helicobacter pylori and cytomegalovirus infections. The most frequent symptom is epigastric pain. Also common are peripheral oedema due to hypoalbuminemia and increased permeability of gastric mucosa. The main diagnostic signs of MD include diffusive enhancement of mucosal folds, foveolar hyperplasia and glandular atrophy with a decrease in the number of main and parietal cells, hypoalbuminemia and peripheral oedema. MD being a very rare condition, the optimal methodfor its treatment is unknown.

Computed tomography view of Menetrier's disease

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[Digestive insufficiency of the stomach in children from the positions of clinical morphology and its role in the assessment of the indications for nutritional support ]

The structure of gastric mucosa (GM) of the stomach fundus (SF) was studied in children with various gastrointestinal diseases. In children, the main structural parameters of the SF (GM thickness, depth of glands and thickness of the mucosal epithelium area) varied widely (3.5-5.3 times). The following ranges were allocated: hypotrophy ("atrophy"), eutrophy (area of mean values) and hypertrophy of SF GM thickness, depth of the glands and thickness of the mucosal epithelium area. Hypotrophy ("atrophy") of the SF glands was found in approximately one third of the children of different age which could lead to decrease in the digestive function of the stomach and cause specific clinical symptoms of dyspepsia. Atrophic changes of SF GM were observed in children of all age groups. Most often (49%), fundic glands hypotrophy was observed in children of early age. With age, the incidence of atrophic changes of SF GM decreased. Atrophic changes in the GM can be detected during microanatomical or histopathological (using morphometry) examination of the SF.

High-resolution real-time compound ultrasound imaging of transient protein-losing gastropathy of childhood

We report the case of a 1.5-year-old girl with transient protein-losing gastropathy with hypertrophic gastric folds (PLGH). The diagnosis of PLGH was made by abdominal ultrasound (US) and not by an upper gastrointestinal (UGI) study as reported in many previous publications. Real-time compound ultrasound imaging showed in high detail the echogenic thickening of the mucosal gastric layer and associated hyperaemia on colour Doppler US. These ultrasonic findings highly correlated with the endoscopic US findings and microscopic changes of the gastric wall in PLGH. An awareness of the high-resolution abdominal ultrasound appearances of PLGH may facilitate earlier diagnosis and obviate the need for an upper GI contrast series.

Menetrier's disease

An 8-year-old girl presented with persistent vomiting, pain abdomen and generalized edema. Barium studies and gastroscopy suggested hypertrophic gastropathy. Histopathological examination pointed the diagnosis towards Menetrier's Disease. There was spontaneous remission and the child required only supportive therapy.

[Ménétriér's disease in children]

Ménétriér's disease in children is a rare disorder that is characterized by the presence of marked protein losing gastropathy associated with enlarged and thickened gastric folds. Abnormal regulation of gastric epithelial growth, probably triggered by an infectious agent, has been suggested as an etiology for this disorder. We describe a case of Ménétriér's disease in a young child and review the current literature encompassing the different aspects of the disease.

Menetrier's disease: report of a transient case associated with chylous ascites

We present a case of transient Menetrier's disease (MD) that was associated with chylous ascites. Using immunohistochemistry, we studied the expression of transforming growth factor alpha in this patient's gastric mucosa biopsy over time; a growth factor that has previously been shown to play an active role in the pathogenesis of MD. Excessive expression and altered localization of transforming growth factor alpha was observed while the patient had active disease with return to the normal pattern after resolution of the disease. This case is the first one reported of transient MD associated with chylous ascites; it lends further credible evidence to the concept that altered transforming growth factor alpha expression may play an important role in the pathogenesis of MD.

[Ménétrier disease. Clinical and histological study of 3 cases]

Three cases of Ménétrier's disease diagnosed and treated in our hospital during the last 15 years are presented. We describe the clinical manifestations as well as the pathological findings; one of the cases was complicated by carcinomatous degeneration. On the basis of our experience, we briefly review the controversial clinical, diagnostic and therapeutic aspects of this rare condition.

Home parenteral nutrition in a child with Menetrier disease

A 4-year-old boy is described with abdominal pain, emesis, weight loss, hypoproteinemia and edema. The diagnosis of Menetrier disease was made based on radiographic studies, gastroscopy and gastric biopsy. There was little response to medical treatment and enteral feedings were poorly tolerated for many weeks. Although Menetrier disease in children has a benign and transient course, we found the use of home hyperalimentation significantly shortened the length of hospitalization and provided adequate nutritional support until the gastric lesions began to resolve.

Remission in a patient with Menetrier's disease: spontaneous or induced by treatment?

Remission in a patient with Menetrier's disease occurred 2 months after presentation with anasarca and marked hypoproteinemia. As such spontaneous remission of Menetrier's disease is unusual, we have analyzed our patient and the only five previously reported cases we could find. In our patient, conservative therapy, depriving the gastrointestinal tract of food, institution of parenteral alimentation, and suppression of gastric secretion appeared to be associated with remission. Such an approach should be tried in other patients with Menetrier's disease.