Pediatric Menetrier's disease (MD) is an uncommon, acute, self-limited hypertrophic gastropathy characterized by enlarged gastric folds associated with epithelial hyperplasia and usually accompanied by protein los...Pediatric Menetrier's disease (MD) is an uncommon, acute, self-limited hypertrophic gastropathy characterized by enlarged gastric folds associated with epithelial hyperplasia and usually accompanied by protein losing gastropathy. Gastric cytomegalovirus infection is found in one third of MD children and its treatment is often associated with remission. Diagnosis often requires fullthickness biopsy due to inability to detect typical histological findings with conventional endoscopic biopsy. We report an uncommon case of non self-limited pediatric MD needing endoscopic mucosal resection for diagnosis which was then successfully treated with octreotide long-acting release (LAR). To the best of our knowledge, this is the first pediatric MD case successfully treated with octreotide LAR. Our experience suggests octreotide LAR as treatment for refractory MD before gastrectomy.展开更多
BACKGROUND Gastric mucosal hypertrophy,also known as Menetrier's disease(MD),is more common in men over 50 years of age,and the cause is unknown.The symptoms of the disease are atypical,mostly accompanied by hypop...BACKGROUND Gastric mucosal hypertrophy,also known as Menetrier's disease(MD),is more common in men over 50 years of age,and the cause is unknown.The symptoms of the disease are atypical,mostly accompanied by hypoproteinemia and edema,and sometimes accompanied by symptoms such as epigastric pain,weight loss,and diarrhea.Most experts believe that the site of the disease is mainly located in the fundus of the stomach and the body of the stomach.We found that the site of the disease in this patient involved the antrum of the stomach.CASE SUMMARY We introduced the case of a 24-year-old woman who had repeated vomiting for 5 d and was admitted to our hospital.After various examinations such as computed tomography and pathology in our hospital,the final diagnosis of the presented case is MD.The salient feature is that the mucosal folds in the fundus and body of the stomach are huge and present in the shape of gyrus.The greater curvature is more prominent,and there are multiple erosions or ulcers on the folds.The patient did not undergo gastric surgery and did not undergo re-examination.She is drinking Chinese medicine for treatment,and her vomiting and abdominal pain symptoms have improved.This disease is relatively rare in clinical practice,and it is easy to be misdiagnosed as gastric cancer,chronic gastritis and gastric lymphoma,etc.CONCLUSION MD can occur in the antrum,it is necessary to raise awareness of the disease and reduce misdiagnosis.展开更多
A 3-year-old boy developed transient protein-losing gastroenteropathy associated with cytomegalovirus (CMV) infection. Both IgG and IgM antibodies to CMV were positive in a serologic blood test. Upper gastrointestinal...A 3-year-old boy developed transient protein-losing gastroenteropathy associated with cytomegalovirus (CMV) infection. Both IgG and IgM antibodies to CMV were positive in a serologic blood test. Upper gastrointestinal endoscopy showed multiple erosions throughout the body of the stomach, without enlarged gastric folds. Histological examination of the biopsy specimens indicated eosinophilic gastroenteritis and CMV infection. The patient had complete resolution without specific therapy for CMV in four weeks. An allergic reaction as well as CMV infection played important roles in the pathogenesis of this case.展开更多
文摘Pediatric Menetrier's disease (MD) is an uncommon, acute, self-limited hypertrophic gastropathy characterized by enlarged gastric folds associated with epithelial hyperplasia and usually accompanied by protein losing gastropathy. Gastric cytomegalovirus infection is found in one third of MD children and its treatment is often associated with remission. Diagnosis often requires fullthickness biopsy due to inability to detect typical histological findings with conventional endoscopic biopsy. We report an uncommon case of non self-limited pediatric MD needing endoscopic mucosal resection for diagnosis which was then successfully treated with octreotide long-acting release (LAR). To the best of our knowledge, this is the first pediatric MD case successfully treated with octreotide LAR. Our experience suggests octreotide LAR as treatment for refractory MD before gastrectomy.
基金Supported by Zhejiang Province Medicine and Health Science and Technology Project,No.2017178699Zhejiang Province Medicine and Health Science and Technology Project,No.2018255136Natural Science Foundation of Zhejiang Province,No.Y19H030056.
文摘BACKGROUND Gastric mucosal hypertrophy,also known as Menetrier's disease(MD),is more common in men over 50 years of age,and the cause is unknown.The symptoms of the disease are atypical,mostly accompanied by hypoproteinemia and edema,and sometimes accompanied by symptoms such as epigastric pain,weight loss,and diarrhea.Most experts believe that the site of the disease is mainly located in the fundus of the stomach and the body of the stomach.We found that the site of the disease in this patient involved the antrum of the stomach.CASE SUMMARY We introduced the case of a 24-year-old woman who had repeated vomiting for 5 d and was admitted to our hospital.After various examinations such as computed tomography and pathology in our hospital,the final diagnosis of the presented case is MD.The salient feature is that the mucosal folds in the fundus and body of the stomach are huge and present in the shape of gyrus.The greater curvature is more prominent,and there are multiple erosions or ulcers on the folds.The patient did not undergo gastric surgery and did not undergo re-examination.She is drinking Chinese medicine for treatment,and her vomiting and abdominal pain symptoms have improved.This disease is relatively rare in clinical practice,and it is easy to be misdiagnosed as gastric cancer,chronic gastritis and gastric lymphoma,etc.CONCLUSION MD can occur in the antrum,it is necessary to raise awareness of the disease and reduce misdiagnosis.
文摘A 3-year-old boy developed transient protein-losing gastroenteropathy associated with cytomegalovirus (CMV) infection. Both IgG and IgM antibodies to CMV were positive in a serologic blood test. Upper gastrointestinal endoscopy showed multiple erosions throughout the body of the stomach, without enlarged gastric folds. Histological examination of the biopsy specimens indicated eosinophilic gastroenteritis and CMV infection. The patient had complete resolution without specific therapy for CMV in four weeks. An allergic reaction as well as CMV infection played important roles in the pathogenesis of this case.
