Menetrier’s disease is characterized by:
Pathophysiology
1) disease of the stomach marked by extreme hypertrophy of mucosal folds and protein loss 2) in adults, related to excessive TGF 3) in children, tends to be self-limited and is related to CMV infection
Signs and Symptoms of Menetrier’s disease
1) usually presents with postprandial pain (usually relieved by antacids) 2) nausea 3) vomiting 4) anorexia 5) weight loss 6) peripheral edema from significant protein loss
Characteristic Test Findings
Laboratory – 1) low serum albumin 2) low gastric pH (owing to reduced gastric acid secretion) Radiology – 3) prominent rugal folds on upper gastrointestinal swallow
Histology/Gross Pathology
1) hypertrophied gastric rugal folds, especially in body and fundus 2) elongated and tortuous “corkscrew” gastric pits 3) massive hyperplasia of mucous cells (foveolar hyperplasia) 4) loss of parietal cells
Inheritance/Epidemiology
1) 4 times more common in men 2) considered a precancerous condition requiring regular endoscopic surveillance
Treatment
1) anticholinergics 2) H2 blockers (cimetidine) 3) proton pump inhibitors (Prilosec) 4) prostaglandings 5) prednisone 6) in severe cases gastrectomy (removal of stomach)
Tips for USMLE
if question mentions a 42 year old man with abdominal pain after eating a meal, a 15 pound weight loss, new-onset swelling of feet and ankles, and an upper GI that shows prominent gastric folds, think Menetrier’s
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