Purpose or Case Report: Menetrier’s Disease is a rare form of hypertrophic gastropathy characterized by excessive mucous secretion, protein loss, and enlarged gastric folds. It poses a diagnostic challenge due to its nonspecific clinical presentation and is often misdiagnosed as more common gastric disorders. Although more prevalent in adults, pediatric cases—frequently associated with cytomegalovirus (CMV) infection—can present acutely and typically resolve spontaneously. We present a case that underscores the importance of recognizing this rare condition in children to ensure timely diagnosis and appropriate management.
A previously healthy 3-year-old boy presented with vomiting, anorexia, wet cough, and prominent periorbital and peripheral edema. Laboratory tests revealed hypoproteinemia, hypoalbuminemia, and elevated stool α1-antitrypsin levels, suggestive of protein-losing enteropathy. CMV viremia was detected, with no leukocytosis or peripheral eosinophilia.
Imaging studies, including abdominal ultrasound and computed tomography, revealed thickened and hyperemic gastric walls, moderate abdominopelvic ascites, and pleural effusion. CT demonstrated markedly enlarged and tortuous gastric folds in the fundus and body, particularly along the greater curvature, with sparing of the antrum and preserved gastric wall thickness between folds. The presence of tiny cystic structures within the thickened folds, likely representing hypertrophied glands, helped differentiate the condition from solid gastric tumors.
The differential diagnosis included eosinophilic gastritis, infectious gastritis (e.g., Helicobacter pylori), Crohn’s disease, Zollinger-Ellison syndrome, gastric lymphoma, gastrointestinal stromal tumors (GISTs), and familial protein-losing enteropathy. Upper gastrointestinal endoscopy confirmed the presence of enlarged polypoid folds in the fundus and body with mucosal hyperemia—findings consistent with Menetrier’s Disease.
This case highlights a classic presentation of pediatric Menetrier’s Disease associated with CMV infection. Recognition of its characteristic features and self-limiting nature in children is crucial to avoid unnecessary diagnostic procedures and interventions. Supportive care remains the cornerstone of treatment.
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