Ménétrier’s Disease as a Gastrointestinal Manifestation of Active Cytomegalovirus Infection in a 22-Month-Old Boy: A Case Report with a Review of the Literature of Korean Pediatric Cases

Abstract

Ménétrier’s disease (MD), which is characterized by hypertrophic gastric folds and foveolar cell hyperplasia, is the most common gastrointestinal (GI) cause of protein-losing enteropathy (PLE). The clinical course of MD in childhood differs from that in adults and has often been reported to be associated with cytomegalovirus (CMV) infection. We present a case of a previously healthy 22-month-old boy presenting with PLE, who was initially suspected to have an eosinophilic GI disorder. However, he was eventually confirmed, by detection of CMV DNA using polymerase chain reaction (PCR) with gastric tissue, to have MD associated with an active CMV infection. We suggest that endoscopic and pathological evaluation is necessary for the differential diagnosis of MD. In addition, CMV DNA detection using PCR analysis of biopsy tissue is recommended to confirm the etiologic agent of MD regardless of the patient’s age or immune status.

Unusual coexistence of Ménétrier disease with adenocarcinoma of the esophagogastric junction: A case report and review of the literature

“…The patient in this study did not have a coexistent infection with CMV, as many other case reports have described, mainly in pediatric populations [22,23]. Neither did he have an H. pylori infection.…”

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 ].…”

Enfermedad de Ménétrier en pacientes pediátricos secundaria a una infección por citomegalovirus. Presentación de dos casos clínicos en un centro de alta complejidad

“…4,5 Diferentes estudios, como la seriada esófago-gastroduodenal (SEGD) y la endoscopía, pueden demostrar inflamación de la mucosa y engrosamiento de los pliegues gástricos. 6 La histología incluye hiperplasia foveolar con dilatación quística, acompañada de atrofia glandular en el cuerpo gástrico. 7 No existe un tratamiento bien establecido para esta enfermedad.…”