Total gastrectomy for the treatment of Menetrier’s disease persistent to medical therapy: A case report

Abstract

Highlights The etiology of Menetrier’s disease is still unclear and no definite diagnostic criteria exist. Our patient presented with a lower extremity DVT as initial sign of Menetrier’s disease. Overexpression of transforming growth factor-α (TGF- α) seems to play a significant role in the pathogenesis of the disease and erbitux is one of the main therapeutic options.

A case report of diffuse hyperplastic gastropathy with multiple polypoid formations in a patient with pernicious anemia, Helicobacter pylori infection, hypergastrinemia and hypoalbuminaemia: Do not forget of Ménétrier’s disease

“…The patient also had pernicious anemia, which leads to hypergastrinemia and hypochlorhydria, further hindering the diagnosis. Retrospectively analyzing the case, the clinical symptoms, iron deficiency anemia and hypoalbuminemia could be explained by MD, which is also strongly associated with HP infection [ 4 ].…”

“…Epigastric pain with fullness, nausea, vomiting and a generalized peripheral edema secondary to hypoalbuminemia are the most commonly referred symptoms of MD [ [1] , [2] , [3] , [4] ]. Gastrointestinal bleeding and diarrhea may also be mentioned by the patient [ 3 ].…”

“…Gastrointestinal bleeding and diarrhea may also be mentioned by the patient [ 3 ]. Serum gastrin levels may be elevated due to low gastric acid secretion [ 4 ]. Laboratory evaluation most often shows hypoalbuminemia, hypochlorhydria, elevated serum gastrin and iron deficiency anemia [ 3 , 4 ].…”

“…In MD, the gastric mucosal usually presents giant rugal folds with polypoid appearance on upper endoscopy, which are considered the hallmark of the disease [ 3 ]. The diagnosis depends on the full-thickness biopsy, showing the loss of the deep glandular component [ 4 ]. However, the diagnosis may be tricky, especially when an unusual endoscopic presentation is associated with other conditions that may mislead the diagnostic evaluation.…”

“…There is no evidence-based guideline for MD treatment. It initially consists of proton-pump inhibitors, high-protein diet, octreotide long-acting release and occasionally intravenous albumin infusion [ 1 , 4 ]. Cetuximab, a monoclonal antibody against EGF (epidermal growth factor), has been associated with regression of disease [ 1 ].…”