Adam R Sweeney1, Maureen K Lynch. 1. University of Washington School of Medicine, A-300 HSC, 1959 NE Pacific Street, Seattle, WA 98195-63, USA. Electronic address: asweeney@uw.edu.
Abstract
INTRODUCTION: Ménétrier's disease (MD) is a rare gastric disorder closely associated with Helicobacter pylori infection characterized by enlarged gastric mucosal folds and hyperplasia of surface mucus-secreting cells classically localized to the gastric body. This disease has significant morbidity and mortality secondary to hypoproteinemia, gastric obstruction, hemorrhage, and increased risk of adenocarcinoma. PRESENTATION OF CASE: We report a 53-year-old female who presented with severe epigastric pain, anorexia, weight loss, and prandial vomiting with serum albumin and chloride levels in the normal range. After serial upper endoscopy with biopsy identified nonspecific inflammatory changes in the absence of H. pylori, surgical exploration was performed with intraoperative tissue samples revealing nondysplastic, foveolar hyperplasia. Gastric antrectomy was performed with gross and microscopic examination verifying the diagnosis of MD. DISCUSSION: The unusual presentation of this case differentiates it from other known cases due to the rare localization of the disease to the gastric antrum, the absence of H. pylori infection, and the uncharacteristically normal serum albumin level on presentation. CONCLUSION: This case may represent an unreported subset of MD where limited surgical resection is demonstrated to offer an exceptional outcome.
INTRODUCTION: Ménétrier's disease (MD) is a rare gastric disorder closely associated with Helicobacter pylori infection characterized by enlarged gastric mucosal folds and hyperplasia of surface mucus-secreting cells classically localized to the gastric body. This disease has significant morbidity and mortality secondary to hypoproteinemia, gastric obstruction, hemorrhage, and increased risk of adenocarcinoma. PRESENTATION OF CASE: We report a 53-year-old female who presented with severe epigastric pain, anorexia, weight loss, and prandial vomiting with serum albumin and chloride levels in the normal range. After serial upper endoscopy with biopsy identified nonspecific inflammatory changes in the absence of H. pylori, surgical exploration was performed with intraoperative tissue samples revealing nondysplastic, foveolar hyperplasia. Gastric antrectomy was performed with gross and microscopic examination verifying the diagnosis of MD. DISCUSSION: The unusual presentation of this case differentiates it from other known cases due to the rare localization of the disease to the gastric antrum, the absence of H. pyloriinfection, and the uncharacteristically normal serum albumin level on presentation. CONCLUSION: This case may represent an unreported subset of MD where limited surgical resection is demonstrated to offer an exceptional outcome.
Authors: William H Fiske; Jarred Tanksley; Ki Taek Nam; James R Goldenring; Robbert J C Slebos; Daniel C Liebler; Amir M Abtahi; Bonnie La Fleur; Gregory D Ayers; Christopher D Lind; Mary K Washington; Robert J Coffey Journal: Sci Transl Med Date: 2009-11-25 Impact factor: 17.956
Authors: P J Dempsey; J R Goldenring; C J Soroka; I M Modlin; R W McClure; C D Lind; D A Ahlquist; M R Pittelkow; D C Lee; E P Sandgren Journal: Gastroenterology Date: 1992-12 Impact factor: 22.682