Endoscopic Surprise: Ménétrier’s disease Volume 3 - Issue 5

Muhammad Mubarak¹, Harleen Kaur Chela²* and Samiullah³

• ¹Gastroenterology Fellow, Department of Gastroenterology & Hepatology, California
• ²Gastroenterology Fellow, Department of Gastroenterology & Hepatology, University of Missouri, Columbia
• ³Assistant Professor, Department of Gastroenterology & Hepatology, Summa Health Group, USA

Received: August 17, 2022;   Published: August 23, 2022

*Corresponding author: Harleen Kaur Chela, Gastroenterology Fellow, Department of Gastroenterology & Hepatology, University of Missouri, Columbia.

DOI: 10.32474/CTGH.2022.03.000174

Abstract PDF

Ménétrier’s disease is an uncommon condition that can present with a wide range of symptoms. It can be associated with potential for malignant transformation as well. Diagnosis is often challenging, and suspicion arises based on endoscopic appearance with pathology needed for confirmation. We present a short case featuring endoscopic and histopathology images.

A 64-year-old male referred for outpatient esophagogastroduodenoscopy (EGD) for evaluation of six-week history of nausea and vomiting associated with early satiety. Patient denied bloody or bilious emesis. The review of systems was negative for weight loss or change in appetite. Family history was negative for gastrointestinal malignancies. Laboratory review was notable for normocytic anemia with hemoglobin level of 12.5 g/dL and elevated blood urea nitrogen (BUN) at 30 mg/dL with normal creatinine level. EGD was remarkable for hypertrophic and edematous changes of the gastric body and fundal rugae with superficial erosions. Anterograde and retrograde endoscopic views revealed hypertrophic and heaped up gastric rugae with erythema (Figure 1).

Figure 1: Images of antegrade and retrograde endoscopic views of gastric body and gastric fundus, respectively; with findings of hypertrophic and heaped up gastric rugae with erythema. Figure 1 (C & D): Gastric biopsies with elongated gastric pits with ulceration and foveolar hyperplasia with Hematoxylin and Eosin staining at 40X and 200X, respectively.

Biopsies obtained from affected sites revealed elongated gastric pits with ulceration and foveolar hyperplasia on histopathological review compatible with Ménétrier’s disease (Hematoxylin and Eosin staining at 40X, c). Differential diagnosis for enlarged gastric folds includes hypertrophic lymphocytic gastritis, gastric MALToma/lymphoma, and gastric adenocarcinoma. Ménétrier’s disease is a rare condition that can be associated with protein loss and gastrointestinal symptoms including vomiting, weight loss, abdominal pain. It can be associated with helicobacter pylori infection and both diagnosis as well as treatment can be challenging. It has also been linked to malignant potential [1].

1. Gore M, Bansal K, Jadhav N (2022) Menetrier Disease. StatPearls.