Menetrier's disease

Menetrier's disease (also known as giant hypertrophic gastritis) is a rare, acquired, gastrointestinal disorder characterized by the massive enlargement of the gastric mucosal folds, particularly in the stomach's body and fundus. The disease is named after the French physician Pierre Eugène Ménétrier, who first described it in 1888. Menetrier's disease is associated with excessive secretion of mucus, leading to protein-losing enteropathy, and a reduction in the number of acid-secreting cells, which can result in hypochlorhydria or achlorhydria. The exact cause of Menetrier's disease remains unknown, but it has been linked to infections with Cytomegalovirus (CMV) in children and Helicobacter pylori in adults. Additionally, overexpression of the growth factor TGF-α (transforming growth factor alpha) has been implicated in its pathogenesis.

Symptoms and Diagnosis

The symptoms of Menetrier's disease can vary but often include nausea, vomiting, abdominal pain, weight loss, and generalized edema due to protein loss. Diagnosing Menetrier's disease involves a combination of clinical evaluation, laboratory tests, and imaging studies. Endoscopy with biopsy is the definitive diagnostic tool, revealing the characteristic enlarged gastric folds and excluding other conditions such as gastric cancer.

Treatment

Treatment of Menetrier's disease is tailored to the individual's symptoms and the severity of their condition. Management strategies may include proton pump inhibitors (PPIs) to reduce gastric acid secretion, H2 receptor antagonists, and antibiotics if an H. pylori infection is present. In severe cases, or when there is significant protein loss, total gastrectomy may be considered. Recent studies have also explored the use of monoclonal antibodies targeting epidermal growth factor receptor (EGFR) as a potential therapeutic approach.

Prognosis

The prognosis for individuals with Menetrier's disease varies. While some patients may experience spontaneous remission, others may develop complications such as gastric cancer. Regular monitoring and follow-up are essential for managing the disease and its associated risks.

Menetrier's disease Resources
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