Menetrier's disease in childhood associated with cytomegalovirus infection: a case report and review of the literature.

Abstract

Menetrier's disease is a rare disorder first described in 1888 (Menetrier, 1888). It is characterised by giant hypertrophic gastritis and protein-losing enteropathy. In adults the disease has a chronic course with a risk of developing gastric carcinoma (Scharschmidt, 1977). However, Menetrier's disease is much rarer in childhood and usually runs a benign course (Burns & Gay, 1968). The aetiology is unknown but five previously reported cases have been associated with cyto-megalovirus (CMV) infection (Lachman et al, 1971; Leonidas et al, 1973; Buts et al, 1978; Floret et al, 1978; Stillman et al, 1981). We report a further case in which CMV was also isolated and discuss the role of this agent in the aetiology. We stress the value of radiology rather than biopsy in the diagnosis and management of the disease in children. A previously well 4-year-old boy presented with a 1-week history of coryzal symptoms, vomiting and anorexia. He had on one occasion passed a small melaena stool but his bowel motions had been otherwise normal. Two days prior to admission his mother noticed that his face, abdomen and legs had become swollen. He had not been on any medication and there was no family or past history of atopy. The other members of his family were asymptomatic. On examination he was afebrile but had moderate oedema of the face and legs with ascites and hepatic enlargement 2 cm below the right costal margin.