Search

Ménétriere´s disease is a rare disorder of the body and fundus of the stomach, characterized by a massive proliferation of the foveolar cells and subsequent excess mucous secretion. This results in hypoproteinemia due to loss of serum proteins across the gastric mucosa. The cause of Ménétriere´s disease is unknown, and due to the irreversible and premalignant character of the disorder, the patients affected have been subdued to gastrectomy as the only curable treatment. Epidermial growth factor (EGF) has been implicated in the pathogenesis, a finding that makes the disorder receptive to monoclonal antibody treatment against the EGF receptor. In this case report, we present a 41-year-old woman referred to our emergency department due to dizziness, nausea, and vomiting. A thorough medical investigation, combining clinical history, laboratory investigations, an upper endoscopy with full-thickness snare biopsies, and a CT scan confirmed Ménétriere´s disease, and she was successfully treated with the monoclonal antibody cetuximab.

Novel treatments for gastrointestinal (GI) diseases are based on molecular targets. Novel pharmacologic and biological agents with greater selectivity and specificity are being developed for a variety of epithelial diseases, including eosinophilic esophagitis (EoE), gastroesophageal reflux disease (GERD), celiac disease, short bowel syndrome (SBS), and inflammatory bowel diseases (IBDs; Crohn's disease and ulcerative colitis). Motility and secretory agents are being developed for gastroparesis, irritable bowel syndrome (IBS), functional constipation, and diarrhea. Here we focus on data from clinical trials involving validated pharmacodynamic or patient response outcomes.

Menetrier's disease is a rare acquired cause of protein losing enteropathy, with premalignant potential. Since its first description in 1888, around 300 cases have been reported. This disease occurs more frequently in males aged 30-50 years. We report here the case of a 31 year- old Sudanese female who presented with generalized edema. Laboratory investigations showed hypoproteinemia and hypoalbuminemia without evidence of renal or liver disease. Upper gastrointestinal endoscopy showed giant gastric folds. The histopathological features of biopsies taken from these folds were consistent with Menetrier's disease. Our patient showed excellent response to treatment with subcutaneous octreotide and this may ameliorate the need for surgery as the definitive treatment of this disease.

The case of a patient with Ménétrier's disease in association with inactive ulcerative colitis of 7 years of evolution is presented. Diagnosis was confirmed by exploratory laparotomy and the symptoms of anemia and hypoproteinemia improved following treatment with octreotide. On review of the literature this was found to be the third case of Ménétrier's disease associated with ulcerative colitis described in the world literature. A possible relationship with an increase in alpha TGF is suggested. The diagnostic criteria and the possible etiopathogenic factors of the disease are herein reviewed.