Menetrier's Disease Research Articles

Oesophageal xanthalasma with Barrett's Oesophagus and Menetrier's Disease.

This case report describes three conditions; oesophageal xanthalasma, Menetrier’s disease and Barrett’s oesophagus, none of which have ever been seen together, diagnosed in one patient. Further to the details of the case the endoscopic, radiological and histological findings are discussed. Any links between these three conditions are currently unclear.

Ménétrier’s disease diagnosed by enteroclysis CT: a case report and review of the literature

This study reports a case of Ménétrier's disease (MD) in an adult who presented with epigastric pain and peripheric edema. We focused in particular on the imaging and diagnostic aspects of the presenting case as well as clinical, histologic, and therapeutic aspects. Computed tomography (CT) enteroclysis is a new imaging technique which combines enteroclysis and spiral multislice CT. To the best of our knowledge this is the first report on a MD in an adult patient diagnosed by CT Enteroclysis.

A Case of Menetrier's Disease Showing Mucus Bridge Observed during Endoscopy

Menetrier's disease is a rare entity characterized by large, tortuous gastric mucosal folds. The mucosal folds in Menetrier's disease are often most prominent in the body and fundus. Histologically, massive foveolar hyperplasia (hyperplasia of surface and glandular mucous cells) is noted, which replaces most of the chief and parietal cells. Profuse mucus is usually observed during the endoscopy but there have been few cases that show interesting endoscopic findings such as mucus bridge or water pearl. Herein, we report a case of Menetrier's disease showing mucus bridge by excessive mucus observed during the endoscopy.

Long-term gastric changes in achlorhydric H+/K+-ATPase beta subunit deficient mice

Objective. Hypergastrinemia is known to induce enterochromaffin-like (ECL) cell derived tumors in rodents and man. In this study, we have examined the effect of life-long gastric anacidity and secondary hypergastrinemia in H+/K+-ATPase beta subunit knockout (KO) mice. Material and methods. Female H+/K+-ATPase beta subunit KO mice and controls were followed up to 20 months before being sacrificed. At termination, intragastric acidity was measured and internal organs were examined for macroscopic and histological changes. Plasma gastrin and serum albumin were measured. Results. KO mice were anacidic and hypergastrinemic. The oxyntic mucosa was markedly, and with increase in age, hyperplastic with cystic dilatations resembling the changes seen in patients with Menetrier's disease. Serum albumin in KO mice did not differ from controls. KO mice had a marked ECL cell hyperplasia, but only one gastric carcinoma was found. Conclusion. H+/K+-ATPase beta subunit KO mice develop Menetrier-like changes in the stomach, and may be useful in studying the pathogenesis and treatment of Menetrier's disease. The reason why only one KO mice developed gastric neoplasia whereas the histamine-2 blocker loxtidine has previously been found to regularly induce ECL cell carcinoids in mice is not known.

Corrigendum to “Menetrier's disease coexisting with ulcerative colitis and sclerosing cholangitis” [Dig. Liver Dis. 40 (2008) 78–80

Corrigendum to “Menetrier's disease coexisting with ulcerative colitis and sclerosing cholangitis” [Dig. Liver Dis. 40 (2008) 78–80

Meta analysis of 95 patients with Ménétrier disease in China

Objective To summarize the clinical features, diagnosis and treatment of Menetrier disease in China. Methods A systematic review of Menetrier disease in China was performed. Four electronic databases were searched from 1993 to 2008 including CNKI and Wanfang seeking studies about pathologically performed Menetrier disease. Results Data of 95 patients with Menetrier disease from 62 studies was included. There were 74 males and 21 females. The mean age of onset in adults was （47.4±5. 3） years . The process of the disease was longer in male individuals that in female individals （47.5 months vs. 13.7 months, P〈0.05）. The main symptoms included abdominal pain （76.8%）, weight loss （42.1%）, anorexia （40.0%） and edema of lower extremities （36.8%）, etc. Hypoproteinemia was accounted for 71.6% and most of the patients had hypochlorhydria. The typical giant hyperplastic gastric fold was found in 88.4% of the patients under endoscopy. The diffuse type was in predominance and mainly involved the greater curve of the stomach （55.3%）. Whereas 5.3%patients were accompanied with gastric cancer. The misdiagnostic rate of the disease was 31. 6%, which accounted for 50% in surgically treated patients. Conclusions In China, the Menetrier disease is predominant in middle-aged males, and the process is longer in males than in females. Misdiagnosis is related to existence of weight loss and hypoproteinemia. Most of the patients with Menetrier disease have a good prognosis even the disease process is long. Key words: Gastritis, hypertrophy; Menetrier disease; Disease attributes

Gastric cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow-up

Although the incidence of gastric cancer is decreasing, there were still 159 900 new cases in Europe in 2006, and ∼118 200 deaths, representing the fifth highest incidence and fourth highest cause of cancer-related death. The peak incidence is in the seventh decade, and the male:female ratio exceeds 1.5. There is marked geographic variation. Risks include male gender, cigarette smoking, Helicobacter pylori infection, atrophic gastritis, partial gastrectomy, Menetrier's disease and genetic factors such as hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, hereditary diffuse gastric cancer and Peutz–Jeghers syndrome.

Menetrier's Disease Accompanied with Adenocarcinoma

증례: 47세 남자 환자가 내원 2주 전부터 시작된 상복부 불쾌감을 주소로 타 병원에 내원하여 시행한 상부소화관 내 시경 검사상 위에 이상소견이 있어 확진 및 치료를 위해 전 원되었다. 환자는 과거력에서 특이사항 없었으며 가족력에 서 큰 형이 위암으로 수술 받은 병력이 있었다. 문진소견에서 1개월 동안 3 kg의 체중감소가 있었으며 혈 압은 110/90 mmHg, 맥박 60회/분, 호흡수 20회/분, 체온 36.8 C였다. 진찰소견에서 전신상태는 양호하였고 두경부, 흉부 및 복부진찰에서 이상소견은 없었다. 검사실 소견으로 말초혈액검사에서 WBC 5,770/mm , Hb 7.7 g/dL, platelet 431,000/mm이었다. 생화학 검사에서는 total protein 3.7 g/dL, albumin 1.4 g/dL, AST/ALT 31/34 U/L, BUN/Cr 8.0/1.1 mg/dL, 총 콜레스테롤 165 mg/dL, 공복혈당 이 81 mg/dL이었다. 요화학 검사는 정상이었다. 상부소화관 내시경 검사에서 전정부를 제외한 위 전반에 걸쳐 미만 위 점막 비후 및 용종 병변이 관찰되었으며(Fig. 1A, B), 식도, 십이지장에는 특이 병변이 없었고, 대장내시 경 검사에서도 특이 소견이 없었다. 내시경초음파 검사에서 병변은 주로 점막층에 국한된 점막 비후 소견을 보였고(Fig. 1C), 복부전산화단층촬영에서도 위 점막 비후 소견이 있었 다(Fig. 2). 내과적인 대증 치료를 시행하였으며 환자의 증상 및 혈액 검사소견이 호전되어 위암에 대한 감시 내시경 검 사를 하면서 추적관찰 하였다. 1년 후 시행한 내시경 검사 에서(Fig. 1D) 조직검사에서 선암종 조직이 관찰되어 위 전 절제술을 시행하였으며(Fig. 3A), 수술 조직에서 소와 증식 을 포함한 점막의 과증식 소견(Fig. 3B), 저도 형성이상을 동 반한 선종(Fig. 3C)과 함께 상부 체부의 전벽에서 점막에 국 한된 고분화도의 선암종을 관찰할 수 있었다(Fig. 3D).

Cytomegalovirus-associated protein-losing gastropathy in childhood

Menetrier's disease is an uncommon disease in childhood, characterized by gastric hypertrophy and hypoalbuminemia secondary to protein loss through the gastric mucosa. This paper describes a series report of protein-losing gastropathy associated with cytomegalovirus (CMV) infection in children and reviews the literature. We reviewed the medical records of eight children with diagnosis of Menetrier's disease or protein-losing gastropathy with evidence of acute CMV infection. During a five-year period there were eight children that were diagnosed with CMV-associated protein-losing gastropathy, all in one medium-sized pediatric ward in a general hospital. The mean age was 32 months and there was no gender predominance. The most common presenting symptoms were vomiting and edema. Average symptoms' duration prior to admission was 3.2 weeks and mean albumin at presentation was 1.8 g/dl (range, 1.5-2.5 g/dl; normal values, 3.5-5 g/dl). All eight children fully recovered. In conclusion, CMV infection should be suspected in every child who presents with protein-losing gastropathy. The availability of newer, rapid diagnostic techniques such as polymerase chain reaction (PCR) may facilitate diagnosis, as serology studies may be misleading. Usually, only supportive care is required, but treatment with ganciclovir may be considered for severe or prolonged cases.

Menetrier’s disease

Menetrier's disease is a rare acquired disorder of the fundus and body of the stomach (ie, oxyntic mucosa) characterized by giant hyperplastic folds, protein-losing gastropathy, hypoalbuminemia, increased mucus secretion, and hypochlorhydria. Recent research implicates overproduction of transforming growth factor-alpha with increased signaling of the epidermal growth factor receptor (EGFR) in the pathogenesis. Activation of the EGFR, a transmembrane receptor with tyrosine kinase activity, triggers a cascade of downstream, intracellular signaling pathways that leads to expansion of the proliferative compartment within the isthmus of the oxyntic gland. The diagnosis of Menetrier's disease is based upon characteristic histologic changes, including foveolar hyperplasia, cystic dilation of pits, and reduced numbers of parietal and chief cells. The best treatment for Menetrier's disease is not clear. It seems reasonable to test and treat for cytomegalovirus and Helicobacter pylori, as 1) in children, evidence exists that the disease may be due to cytomegalovirus infection in up to one third of patients; and 2) in adults, there are anecdotal reports of resolution upon H. pylori eradication. More recently, therapies targeting increased signaling of the EGFR have shown promise, including somatostatin analogues and monoclonal antibodies (eg, cetuximab) directed against the EGFR. In refractory cases, gastrectomy is curative.

Primary Squamous Cell Carcinoma of the Stomach That Developed with Menetrier's Disease

Primary Squamous Cell Carcinoma of the Stomach That Developed with Menetrier's Disease

Menetrier’s disease in a patient with ulcerative colitis: a case report and review of the literature

Sir,Menetrier's disease is an uncommon entity characterised by massive foveolar hyperplasia of the gastric mucosa, typically confined to the gastric body and associated with hypoalbuminaemia. Most ...

Endoscopic Doppler US probe for the diagnosis of gastric varices (with videos)

Gastric varices may appear similar to enlarged gastric folds and submucosal neoplasms at endoscopy. A simple endoscopic method to diagnose variceal blood flow without formal EUS could be clinically useful. To demonstrate the use of Doppler US (DOP-US) in the diagnosis of gastric varices. Case series. A tertiary-care U.S. academic medical center. Eight patients with findings of gastric submucosal lesions of uncertain etiology on EGD. EGD with DOP-US examination, with or without standard EUS. Presence or absence of audible DOP-US signal and EUS findings for gastric submucosal lesions. DOP-US demonstrated a reproducible continuous venous hum in 5 cases of gastric varices (confirmed by EUS in 2 cases). A sixth case of gastric varices demonstrated pulsatile flow with DOP-US (confirmed by EUS). In 1 case of a GI stromal tumor (GIST) in the stomach, no signal was heard when the lesion itself was examined by DOP-US. In a final case of Menetrier's disease, no signal was heard when the giant gastric folds were examined. DOP-US can help differentiate gastric varices from other gastric submucosal lesions. The use of DOP-US may obviate the need for EUS to confirm gastric varices when the EGD diagnosis is uncertain.

CCR7 deficiency causes ectopic lymphoid neogenesis and disturbed mucosal tissue integrity

AbstractHomeostatic trafficking of lymphocytes through extralymphoid tissues has been recently observed, and a potential role in immune surveillance and the establishment of peripheral tolerance are considered. However, the mechanisms regulating lymphocyte recirculation through peripheral tissues under noninflammatory conditions are not well understood. Here, we demonstrate that the chemokine receptor CCR7 controls not only lymphocyte trafficking to and within secondary lymphoid organs but also homeostatic migration of T and B lymphocytes through nonlymphoid tissues. Lack of CCR7 results in a massive accumulation of lymphocytes in epithelial tissues. In particular, the gastrointestinal mucosal tissue of CCR7−/− mice is highly permissive for the formation of lymphoid aggregates, which develop into ectopic follicular structures with major topologic characteristics of lymph nodes. Flow cytometry analysis of CD4+ T cells derived from ectopic follicles revealed that CD44hiCD62Llo effector memory T cells predominate in the gastric lymphoid aggregates. In aged mice, lack of CCR7 induced age-dependent histomorphologic changes in the stomach with profound cystic hyperplasia and an increased rate of mucosal proliferation resembling Menetrier disease. Thus, CCR7 regulates the cellular organization of visceral tissue by governing life-long recirculation of naive and memory lymphocytes under homeostatic conditions.

Menetrier's disease and cytomegalo virus infection in a child

Menetrier's disease and cytomegalo virus infection in a child

Integrative roles of transforming growth factor-α in the cytoprotection mechanisms of gastric mucosal injury

BackgroundTransforming growth factor α (TGFα) protects against gastric mucosal injury and facilitates wound healing. However, its overexpression is known to induce hypertrophic gastropathy resembling Menetrier's disease in transgenic (TG) mice on an FVB background, as one of the authors reported previously. We studied another TGFα-expressing mouse line on a CD1 background, whose gastric mucosa appears normal. Since this TG mouse had a strong resistance to ethanol-induced gastric injury, we considered the long-term effect of TGFα on several gastric protection mechanisms.MethodsTGFα-expressing transgenic (TG) mouse lines bearing human TGFα cDNA under the control of the mouse metallothionein gene I promoter were generated on a CD1 mouse background, and analyzed their ethanol injury-resistant phenotypes produced by TGFα.ResultsIn the TG mucosa, blood flow was well maintained after ethanol injury. Further, neural and inducible types of NO synthases were consistently and widely expressed in the TG mucosa, compared with the limited distribution of neural type NO synthase in the luminal pit region of the wild-type (WT) mucosa. COX-2 and its upstream transcription factor NfkB were constitutively elevated in the TG mucosa even before ethanol administration, whereas they were induced in the same region of the WT mucosa only after ethanol injury. Two anti-apoptotic proteins, HSP70 and Bcl-2, were upregulated in the TG mucosa even before ethanol administration, while they were not expressed in the WT mucosa before the injury. Furthermore, pro-caspase 3 activation was inhibited in the TG mucosa, while it was converted to the active form in the WT mucosa following ethanol administration.ConclusionWe conclude that TGFα maintains the gastric mucosal defense against gastric injury by integrating other cytoprotective mechanisms.

Contrast-Enhanced Ultrasonographic Assessment of the Response of Ménétrier Disease toHelicobacter pyloriEradication Therapy

Recent improvement in ultrasonographic devices, techniques, and contrast agents has allowed more detailed investigation of the vascularity and inflammatory characteristics of gastrointestinal tract diseases, and investigators have reported that contrast-enhanced ultrasonography (CEUS) is as useful as endoscopic ultrasonography (EUS) for evaluation of the pathogenesis of gastrointestinal tract disease. 1 There have been a few reports that transabdominal color Doppler ultrasonography is useful in the diagnosis of Menetrier disease and evaluation of the therapeutic response, 2 but there have been no reports on CEUS evaluation of Menetrier disease. In addition, it has been reported that Helicobacter pylori infection plays an important role in Menetrier disease, and eradication therapy can provide a cure. 3 We report a case of Menetrier disease cured by H pylori eradication therapy in which the therapeutic response was assessed by CEUS.

Menetrier's disease and cytomegalovirus infection in a child

Menetrier's disease and cytomegalovirus infection in a child

Menetrier's disease: a case report

患者男,55岁.2个月前无明显诱因出现双下肢水肿,同时稍感上腹部不适,进食后尤其明显,食欲减退,于2005年6月19日入院.入院前于外院CT检查示:胃壁平滑肌瘤可能性大,胃腔变小,胃镜检查未见明显异常.上消化道造影提示:胃癌、右侧胸膜肥厚.外科查体:腹平坦,全腹无压痛、反跳痛及肌紧张,左上腹可触及一8 cm×9 cm×15 cm大小的肿块,无触痛,双下肢出现凹陷性水肿.实验室检查:白蛋白25 g/L。

Maladie de Ménetrier révélée par une invagination gastro-duodénale

The authors report a very rare case of gastroduodenal intussusception complicating Menetrier's disease. This uncommon condition of unknown aetiology is characterized by hyperplasia of the gastric mucosal folds. Computed Tomography (CT) in high resolution mode can be helpful for diagnosis by showing the cerebriform surface of the giant mucosal folds. Filling the gastoduodenal tract with water is useful in non complicated cases.