Menetrier Disease : Causes, Etiology, Pathophysiology, Signs, Symptoms, Diagnosis, Radiology, Histology, Management, & Prevention
Synonym: Hypoproteinemic Hypoalbuminic Hypertrophic Gastropathy
Definition
- Menetrier Disease is acquired hypertrophic protein losing gastropathy with giant gastric mucosal rugal folds in the stomach (body & fundus) with cobblestone appearance.
- Proximal part is involved (antrum is not involved) i.e. antral sparing.
- Common in males.
- Overexpression of transforming growth factor α (TGFα) ⇓ Increased chances of cancer
Pathology
Associated with
- Adults: Helicobacter pylori
- Children: CMV (Cytomegalovirus)
Histology
- Mucosal thickening
- Gastric gland atrophy
- Deep crypts
- Foveolar surface mucus cell hyperplasia
All cells replaced by mucus cells (including absence of parietal cells)
↓
Excessive mucus production
Protein loss
Achlor/hypochlorhydria
Clinical Features
- Epigastric pain
- Anemia
- Weight loss
- Melaena (Dark tarry stool with or without visible blood)
Investigations
1. Endoscopy ⇒ Biopsy
2. CECT
3. Barium meal studies
4. Gastric function tests
4. Serum total protein, albumin
Treatment
A. Mild to moderate cases
- Only supportive treatment
⇓
High protein diet
H2 blockers or PPI
Steroids
Anticholinergics
Antibiotics
Antiviral drugs
- Monoclonal antibody
B. Severe cases (If there is massive protein loss or dysplasia or carcinoma)
Total gastrectomy
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