The cases of 43 patients with hypoproteinemic hypertrophic gastropathy (Ménétrièr's disease) seen at the Mayo Clinic during 1970 to 1980 are reviewed. Characteristically, patients with Ménétrièr's disease are older than 60 years of age and have epigastric pain, weight loss, nausea, diarrhea, and dyspepsia, with or without a history of peptic ulcer disease. Ménétrièr's disease can be associated with swelling in the extremities, vomiting and early satiety, maculopapular rash, anorexia, and fatigue. In our patients, unlike those with hypertrophic gastropathy without hypoproteinemia, Ménétrièr's disease was accompanied by an increased incidence of severe or recurrent infections (18 patients); occlusive, thromboembolic, and other vascular disorders (23 patients); and pulmonary edema (13 patients). Remission can occur after parietal cell vagotomy or histamine-H2-receptor blockade, or spontaneously; however, in most patients, rugal enlargement and hypoproteinemia persist for long periods of time.
Ventilation (V) increases lung lymph flow (Ql), but the separate effects of tidal volume (Vt) and frequency (f) and the role of V-induced changes in edema formation are poorly understood. An isolated, in situ sheep lung preparation was used to examine these effects. In eight sheep with f = 10 min(-1), results obtained during 30-min periods with Vt = 5 or 20 ml/kg were compared with values obtained during bracketed 30-min control periods (Vt = 12.5 ml/kg). Eight other sheep with constant Vt (12.5 ml/kg) were studied at f = 5 or 20 min(-1) and compared with f = 10 min(-1). Three additional groups of six sheep were perfused for 100 min with control V (10 ml/kg, 10 min(-1)). Vt was then kept constant or changed to 20 or 3 ml/kg during a second 100-min period. Increases in Vt or f increased Ql and vice versa, without corresponding effects on the rate of edema formation. For the same change in V, changing Vt had a greater effect on Ql than changing f. The change in Ql caused by an increase in Vt was significantly greater after the accumulation of interstitial edema. The change in Ql caused by a sustained increase in Vt was transient and did not correlate with the rate of edema formation, suggesting that V altered Ql through direct mechanical effects on edema-filled compartments and lymphatic vessels rather than through V-induced changes in fluid filtration.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.