Menetrier's disease. A diagnostic and therapeutic challenge.

Abstract

We present a rare case of hypertrophic gastropathy associated with protein loss. A 35-year-old man was hospitalized for bowel habit changes, abdominal pain, generalized edema and symptomatic anemia. Pertinent laboratory findings included iron deficiency anemia (Hb 6.7g/dl, ferritin 5 ng/ml) and marked hypoalbuminemia (albumin 2.5 g/dl). Endoscopic biopsy samples of giant gastric folds observed along the greater gastric curvature revealed foveolar hyperplasia and significant parietal cell loss. Endoscopic ultrasonography showed gastric parietal thickening with preserved architecture and normal gastric wall layers. Menetrier disease was diagnosed and the patient treated with cetuximab, a monoclonal antibody that inhibits ligand binding of transforming growth factor alpha (TGFa), preventing gastric mucosa cell proliferation. After twelve months of treatment, the patient referred symptoms improvement, and gastric biopsy levels of the proliferation marker protein Ki-67 had decreased.

• Authors: Pablo Pepa, Tatiana Uehara, Andrés Wonaga, Agustina Redondo, Alejandra Avagnina, Octavio Mazzocchi, Pablo Antelo, Carlos Waldbaum, Juan Sorda
• Journal: Medicina (Medicina (B Aires)) Vol. 81 Issue 3 Pg. 470-473 ( 2021) ISSN: 1669-9106 [Electronic] Argentina
• Vernacular Title: Enfermedad de Menetrier. Un desafío diagnóstico y terapéutico.
• PMID: 34137712 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal

Topics

• Adult
• Antibodies, Monoclonal
• Biopsy
• Gastric Mucosa
• Gastritis, Hypertrophic (diagnosis, drug therapy)
• Gastroscopy
• Humans
• Male