An unusual association of Ménétrier's disease with a gastric bezoar

Abstract

Ménétrier’s disease is a rare protein-losing hypertrophic gastroenteropathy. While it still remains a medical curiosity, infection with Cytomegalovirus andHelicobacter pylori, and hormonal, congenital, dietary and neurogenic factors have been postulated as causative factors. We describe a case of a 14-year boy who presented with epigastric discomfort, vomiting, inability to gain weight and pedal oedema. Investigations revealed hypoproteinaemia without proteinuria and elevated faecal α-1-antitrypsin levels suggestive of protein-losing enteropathy. Imaging and endoscopic features demonstrated cerebriform gastric folds indicative of Ménétrier’s disease. Infective, hormonal and neurogenic causes were ruled out in our patient. Surprisingly, the patient had a history of pica and an associated large gastric bezoar, which was ultimately removed surgically. An association of Ménétrier’s disease with a bezoar has been reported only once previously. We thus add to the existing literature and highlight the plausible role of a bezoar as a causative factor in the pathogenesis of Ménétrier’s disease due to its irritant nature.

Diagnosis and Management of Ménétrier Disease in Children: A Case Series Review

“…The symptoms described in adults (males are more commonly affected than females) include vomiting, nausea, abdominal pain, diarrhea, weight loss, malnutrition, and peripheral edema secondary to hypoalbuminemia [ 1 5 ]. Children with MD often demonstrate a prodromal phase caused by a transient viral infection, followed by edema and gastro-intestinal symptoms, including emesis, epigastric pain, anorexia, diarrhea, vomiting, and abdominal pain ( Table 2 ) [ 3 4 6 7 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 ]. Edema is caused by hypoalbuminemia as a result of protein loss as a consequence of edema of the gastric mucosa [ 4 ].…”

Upper Gastrointestinal Manifestation of Bezoars and the Etiological Factors: A Literature Review

“…It is a long-term genetic disorder that affects the function muscles characterized by progressive destruction of striated muscular fibers that may often contract and/or unable to relax [32, 33]. (9-10) Rarely, intragastric bezoar may be associated with multiple myeloma [51] and Ménétrier's disease [34]. Ménétrier's disease is a rare condition characterized by gyriform or nodular enlargement of gastric mucosal folds and protein-losing hypertrophic gastroenteropathy.…”