A Rare case of Menetrier’s disease presenting with Protein Losing Gastropathy Mimicking Carcinoma Stomach

Richmond Ronald Gomes

doi:10.31579/2641-5194/025

Abstract

Ménétrier's disease (MD) (also known as giant hypertrophic gastritis or hypoproteinemic hypertrophic gastropathy) is a rare premalignant entity characterized by markedly hypertrophied mucosal folds of the fundus and the gastric corpus typically associated with , hypochlorhydria, protein losing enteropathy causing hypoalbuminemia and anemia. However, the natural history of MD in adults remains unclear and is rarely reported in the literature. Its constellation of classic symptoms includes nausea, vomiting, abdominal pain and peripheral edema, and it is associated with increased risk of gastric cancer. Nevertheless, its pathophysiology is not yet fully understood and clinical and endoscopic diagnosis can be difficult to establish. Malignant transformation in MD should not be overlooked, and regular monitoring of the gastric mucosa via endoscopy is necessary.

Highlights

Menetrier’s disease (MD) is a rare disease that was first described by the French pathologist Pierre Menetrier(1859-1935) in the Archives de Physiologie Normale et Pathologique in 1888 [1].It is a rare acquired hypertrophic gastropathy leading to dilatation of the mucus-secreting gastric pits on the expense of the gastric glands containing the acid-producing parietal cells and pepsinogen-producing chief cells which undergoes atrophy
Rich et al [2], proposed an algorithm for the diagnosis of Ménétrier's disease (MD) that rely on clinicohistopathological analysis of the following criteria: upper GIT endoscopy with gastric pH, appropriate laboratory tests (CBC, serum albumin, serum gastrin, H. pylori and CMV) and full thickness mucosal biopsy
MD should be suspected in cases of upper GIT symptoms and hypertrophied gastric mucosa with or without H. pylori or hypoalbuminemia

Summary

Introduction

Menetrier’s disease (MD) is a rare disease that was first described by the French pathologist Pierre Menetrier(1859-1935) in the Archives de Physiologie Normale et Pathologique in 1888 [1].It is a rare acquired hypertrophic gastropathy leading to dilatation of the mucus-secreting gastric pits (fovula) on the expense of the gastric glands containing the acid-producing parietal cells and pepsinogen-producing chief cells which undergoes atrophy. These changes gives the disease it characteristic features of the huge expansion of gastric mucosa, thick mucus secretion, protein loss and hypochlorhydria [2]. There is a plan to follow him up by surveillance endoscopy once or twice per year

Discussion

Conclusion