Denudation of basal membrane: an ultrastructural correlate of impaired membrane transport in protein losing gastroenteropathy ( PLGE )

Abstract

Gastropathia hypertrophica gigantea MENETRIER in PLGE has only been reported 14 x in children; its etiology is unknown. A 5 y old boy showed vomiting of unusually viscous gastrie juice, severe anorexia during measles, generalized edema and hypoproteinemia of 3.0g%. No evidence for chronic malnutrition, allergy, renal, cardial or liver disease. 12.5% of the radioactivity(RA) of an iv dose of 51cr albumin appeared in a 72 h fecal collection(no <0.7%); 50.5% of RA appeared within 2 1/4 h in gastric juice with a protein output of ca 300 mg/h equivalent to an albumin loss of ca 8 g/d which exceeds the rate of albumin synthesis and thus explains hypoproteinemia. Pentagastrin iv adm. revealed a “sealing effect” for protein, Na, K, and Cl possibly of therapeutical importance. Electron microscopy revealed(1) numerous microvilli as a manifestation of increased resorptive processes and(2) a denudation of the basal membrane from their endothelial cells in the capillaries, thus manifold enlarging the interendothelial porus. This observation may well be of pathogenetic relevance.