Abstract
Menetrier's disease (MD) is described as hypertrophied giant gastric folds causing hypoproteinemia due to protein losing gastropathy and is associated with higher risk of gastric adenocarcinoma. We present a case of a 58-year-old male who presented to our clinic with Melena and endoscopic work up showed enlarged gastric folds and erythematous mucosa in the antrum and three nonbleeding angioectasias in the duodenum. Mucosa biopsies were negative for H. pylori infection. He underwent polypectomy which showed fundic gland polyps. After 1½ years, EGD was repeated for abnormal computerized tomography of abdomen which showed enlarged gastric folds and biopsy revealed gastric fundic mucosa with foveolar hyperplasia, dilated fundic glands, and chronic gastritis. Stomach biopsy results were consistent with MD. Our patient had progressive disease in one and half years. It is important to follow patient with large gastric folds regular as they can develop MD over time which has increased risk of gastric adenocarcinoma.
Highlights
Menetrier’s disease (MD) is a rare clinical disease which is characterized by abnormal hypertrophy of gastric folds; causing hypoproteinemia due to protein losing gastropathy [1]
Our case is a unique example of MD that is without hypoalbuminemia and without gastric colonization with H. pylori like other similar cases reported in literature [5, 10]. is points out to the fact that further research is needed in understanding the pathophysiology of the disease in addition to H. pylori infection and low serum albumin levels
It is well known that adult MD occurs in the setting of H. pylori infection of the stomach [11, 12]
Summary
MD is a rare clinical disease which is characterized by abnormal hypertrophy of gastric folds; causing hypoproteinemia due to protein losing gastropathy [1]. It causes hypochloremia and associated with increased chances of gastric adenocarcinoma. E disease is diagnosed with clinical features and further laboratory testing including serum albumin levels, EGD, and testing for H. pylori [4, 7] It is commonly treated with proton pump inhibitors, high protein diet, H. pylori eradication, cetuximab (monoclonal antibody), and somatostatin analog injections octreotide long-acting release [4, 6, 8]. In severe progressive disease and medically resistant cases, total and partial gastrectomy are required for management
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