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Hypertrophic Gastritis

Menetrier Disease


Presentation

  • Individuals with the disease present with upper abdominal pain (epigastric), at times accompanied by nausea, vomiting, loss of appetite, edema, weakness, and weight loss.[en.wikipedia.org]
  • Affected patients typically present with abdominal pain, vomiting and nausea. Edema of peripheral tissues is often found. Other symptoms include asthenia, anorexia, and weight loss.[orpha.net]
  • Clinical manifestations, laboratory data, and roentgenologic diagnostics of this disease are presented. The child died with the clinical signs of cardiorespiratory insufficiency, and the diagnosis of Ménétrier's disease was established postmortem.[ncbi.nlm.nih.gov]
  • A case of an unusual hypertrophic gastropathy confined to the gastric antrum which presented with chronic anaemia is described.[ncbi.nlm.nih.gov]
  • We report a case of pseudo-Zollinger-Ellison syndrome in a 17-year-old man presenting with gastrin levels exceeding 2000 pmol/l and BAO 24 mEq/hr.[ncbi.nlm.nih.gov]
Recurrent Infection
  • In our patients, unlike those with hypertrophic gastropathy without hypoproteinemia, Ménétrièr's disease was accompanied by an increased incidence of severe or recurrent infections (18 patients); occlusive, thromboembolic, and other vascular disorders[annals.org]
  • Complications include severe or recurrent infections and vascular thromboembolism.[orpha.net]
Weight Gain
  • FMS Nausea and Gastroparesis weight loss weight gain abdominal pain abdominal bloating erratic blood glucose levels The prognosis with surgery is acid reflux include chewing gum after a meal and eating a bit of licorice. foods to eat to prevent heartburn[ict-accordance.eu]
Gastropathy
  • A case of an unusual hypertrophic gastropathy confined to the gastric antrum which presented with chronic anaemia is described.[ncbi.nlm.nih.gov]
  • Genetic counseling MD is an acquired gastropathy but a genetic predisposition with autosomal dominant inheritance has been suggested in a few families. Management and treatment There is no recommended standard treatment.[orpha.net]
  • Gastric cancer has been reported at diagnosis or during follow-up in patients with hypertrophic gastropathy.[nejm.org]
  • It is rather considered as one of the two most well understood hypertrophic gastropathies; the other being Zollinger–Ellison syndrome.[en.wikipedia.org]
Nausea
  • She had a 3-month history of nausea and burning abdominal pain. Radiographic studies showed giant rugal hypertrophy. Superficial endoscopic gastric biopsies showed mild inflammation with plasma cells of polyclonal origin in the mucosa.[ncbi.nlm.nih.gov]
  • Symptoms include nausea, vomiting, pain in the abdomen, swelling, poor appetite, and weight loss. The cause of the disease is not known, although infections with cytomegalovirus and Helicobacter pylori have been suspected to play a role.[medicinenet.com]
  • Commonly seen symptoms are – nausea, vomiting, heartburn, pain in the upper middle region of the abdomen and diarrhea. There will be loss of appetite and weight loss as well.[simple-remedies.com]
  • Symptoms include epigastric pain, nausea, vomiting, weight loss, and abdominal distension.[medical-dictionary.thefreedictionary.com]
  • Characteristically, patients with Ménétrièr's disease are older than 60 years of age and have epigastric pain, weight loss, nausea, diarrhea, and dyspepsia, with or without a history of peptic ulcer disease.[annals.org]
Abdominal Pain
  • She had a 3-month history of nausea and burning abdominal pain. Radiographic studies showed giant rugal hypertrophy. Superficial endoscopic gastric biopsies showed mild inflammation with plasma cells of polyclonal origin in the mucosa.[ncbi.nlm.nih.gov]
  • Affected patients typically present with abdominal pain, vomiting and nausea. Edema of peripheral tissues is often found. Other symptoms include asthenia, anorexia, and weight loss.[orpha.net]
  • Individuals with the disease present with upper abdominal pain (epigastric), at times accompanied by nausea, vomiting, loss of appetite, edema, weakness, and weight loss.[en.wikipedia.org]
  • Clinical signs included emesis, diarrhea, hunched posture consistent with abdominal pain, anemia, and hypoproteinemia. Large gastric masses were present and in one case created a gastric outflow obstruction.[ingentaconnect.com]
  • However, the most common symptoms include: Nausea or recurrent upset stomach Abdominal bloating Abdominal pain Vomiting Indigestion Burning or gnawing feeling in the stomach between meals or at night Hiccups Loss of appetite Vomiting blood or coffee ground-like[webmd.com]
Epigastric Pain
  • Symptoms include epigastric pain, nausea, vomiting, weight loss, and abdominal distension.[medical-dictionary.thefreedictionary.com]
  • Characteristically, patients with Ménétrièr's disease are older than 60 years of age and have epigastric pain, weight loss, nausea, diarrhea, and dyspepsia, with or without a history of peptic ulcer disease.[annals.org]
  • pain, weight loss and diarrhoea melaena. [ 5 ] The severe hypoproteinaemia can result in ascites and gross oedema.[patient.info]
  • Common signs and symptoms of Giant Hypertrophic Gastritis, exhibited are: Nausea, vomiting Diarrhea Epigastric pain: Pain in the upper middle region of the stomach Weight loss Anorexia (loss of appetite) Hypoalbuminemia - low levels of the protein albumin[dovemed.com]
  • pain, vomiting, edema, anorexia, and weight loss.[nejm.org]
Loss of Appetite
  • Individuals with the disease present with upper abdominal pain (epigastric), at times accompanied by nausea, vomiting, loss of appetite, edema, weakness, and weight loss.[en.wikipedia.org]
  • Granular hypertrophic gastritis Characterized by loss of appetite, pain in the upper abdomen, and General weakness. The pain become strong in the morning. Patient have constipation, diarrhea.[gastric.vsebolezni.com]
  • EGFR Grossly and radiologically resembles Zollinger-Ellison syndrome Localized Menetrier disease: Rare localized hyperplastic gastropathy, associated with stomach adenocarcinoma ( Am J Surg Pathol 1997;21:1334 ) Symptoms: upper abdominal discomfort, loss[pathologyoutlines.com]
  • However, the most common symptoms include: Nausea or recurrent upset stomach Abdominal bloating Abdominal pain Vomiting Indigestion Burning or gnawing feeling in the stomach between meals or at night Hiccups Loss of appetite Vomiting blood or coffee ground-like[webmd.com]
  • There will be loss of appetite and weight loss as well. In extreme cases, there will be low levels of the protein albumin which causes accumulation of fluid in the abdomen. Gastrointestinal bleeding has been reported in some cases too.[simple-remedies.com]
Papule
  • An actiniform eruption with pustular lesions and erythematous papules developed across his face and chest during the first week of treatment. These lesions responded to topical clindamycin therapy.[nejm.org]
Suggestibility
  • These findings suggest that the carcinoid tumour was producing a substance which stimulated increased local synthesis of prostaglandin E2 in the gastric mucosa, with concomitant gastric mucosal hypertrophy and inhibition of gastric acid secretion.[ncbi.nlm.nih.gov]
  • Our findings suggest dominant heredity, but considering the sparsity of familial occurrence reported earlier, heredity seems to be of only minor pathogenetic significance.[ncbi.nlm.nih.gov]
  • • All have hyperrugosity or enlarged folds, usually in the body and fundus of stomach • Coarse duodenal folds are usually associated with large folds in the stomach • Most often, enlarged gastric folds are normal • Factors which suggest large folds are[learningradiology.com]
  • […] across the gastric mucosa, severe hypoproteinaemia. [ 2 ] A similar hypertrophic gastritis has been recognised with Helicobacter pylori infection and in children associated with cytomegalovirus infection (a self-limiting condition). [ 3 ] Recent work suggests[patient.info]
  • Pronounced gastric glandular hyperplasia and lack of evidence of cellular atypia were suggestive of giant hypertrophic gastritis. The dog was treated with prednisolone, cimetidine, and hyoscine butylbromide, only to experience a short-term remission.[ncbi.nlm.nih.gov]

Workup

Hypochlorhydria
  • He had marked hypochlorhydria in response to pentagastrin stimulation (Peak acid output (PAO) pg:0.2 mmol/h).[ncbi.nlm.nih.gov]
  • • Hypertrophic hypersecretory gastropathy • Hypersecretion of gastric acid • Hypertrophic hypersecretory gastropathy with protein loss • Hypersecretion of gastric acid • Menetrier’s Disease- fundus and body, esp. greater curvature • Low acid output- hypochlorhydria[learningradiology.com]
  • The abnormalities of the stomach are highly characteristic with giant folds, excess mucus secretion by the lining of the stomach, and hypochlorhydria (decreased acid secretion by the stomach). The disease tends to lead to stomach cancer.[medicinenet.com]
  • Twenty-four-hour pH monitoring reveals hypochlorhydria or achlorhydria, and a chromium-labelled albumin test reveals increased GI protein loss. Serum gastrin levels will be within normal limits.[en.wikipedia.org]
  • MÉnÉtrier's disease (hypoproteinemic hypertrophic gastropathy) is a rare, acquired, premalignant disorder of the stomach. 1-4 It is characterized by giant hypertrophic folds that most often involve the fundus, excess mucus secretion, decreased acid secretion (hypochlorhydria[nejm.org]

Treatment

  • Management and treatment There is no recommended standard treatment. In some patients, treatment may be limited to supportive care with a high-protein diet.[orpha.net]
  • Of the seven patients who completed the 1-month course of treatment, all showed statistically significant improvement both clinically (quality-of-life indices) and biochemically (increased parietal cell mass and gastric acidity).[ncbi.nlm.nih.gov]
  • […] cells after one month of treatment ( Figure 2B ).[nejm.org]
  • In adults, there is no FDA approved treatment other than gastrectomy and a high-protein diet.[en.wikipedia.org]

Prognosis

  • Prognosis MD tends to be a progressive disorder. Most of the patients ultimately require gastrectomy, either due to worsening symptoms or the risk of developing gastric cancer. The risk of malignant transformation is not well characterized.[orpha.net]
  • Treatment and prognosis high-protein diet to correct hypoproteinemia proton pump inhibitors (PPI) to treat attendant gastritis EGFR monoclonal antibody (cetuximab) gastrectomy History and etymology It is named after Pierre Ménétrier (1859–1935), a French[radiopaedia.org]
  • Both aggressive medical and surgical treatments were unrewarding for long-term management of hypertrophic gastropathy in this pair of red-capped mangabeys and resulted in a poor prognosis in these cases.[ingentaconnect.com]
  • What Is the Prognosis for Gastritis? Most people with gastritis improve quickly once treatment has begun.[webmd.com]

Etiology

  • Etiology The etiology is currently unknown but is thought to be acquired and to involve enhanced epidermal growth factor receptor (EGFR) signaling in the gastric mucosa with local overproduction of transforming growth factor-alpha (TGF-alpha).[orpha.net]
  • The etiology remains unresolved and an effective treatment has yet to be established.[joi.jlc.jst.go.jp]
  • Formerly a disorder with an uncertain etiology, Ménétrier disease is now believed to result from enhanced EGFR signaling in the gastric mucosa due to local overproduction of TGF-α (Table 1 ).[jci.org]

Epidemiology

  • Summary Epidemiology Exact prevalence and incidence data are not available. MD appears to affect males slightly more than females.[orpha.net]
  • Molecular and epidemiologic evaluations of a cluster of cases of Menetrier's disease associated with cytomegalovirus. Pediatr Infect Dis J 1993 ;12: 1011 - 1014 8. Bayerdorffer E, Ritter MM, Hatz R, Brooks W, Ruckdeschel G, Stolte M.[nejm.org]
Sex distribution
Age distribution

Pathophysiology

  • Here we show that histamine H 2 -receptor deficient mice developed gastric pathophysiological changes resembling Menetrier's disease for up to 17 months of observation.[joi.jlc.jst.go.jp]
  • Epidermal growth factor-related peptides and their relevance to gastrointestinal pathophysiology. Gastroenterology 1995 ;108: 564 - 580 26. Karam SM. Dynamics of epithelial cells in the corpus of the mouse stomach. IV.[nejm.org]

Prevention

  • […] acid secretion by the stomach The low level of acid secretion results in a failure to digest proteins and absorb nutrients, leading to diarrhea, weight loss, and peripheral edema The cause of the condition is unknown and currently there is no method to prevent[dovemed.com]
  • Therefore, in order to fully disclose the topic, it remains to dwell on the methods of preventing pathology. The first thing that needs to be done is to revise your diet and diet.[acikgunluk.net]
  • Early detection of hypertrophic gastritis and its treatment contributes to the normalization of the stomach and to prevent the development of complications. The most dangerous of them is the degeneration of the tumor in cancer.[gastric.vsebolezni.com]
  • FMS Nausea and Gastroparesis weight loss weight gain abdominal pain abdominal bloating erratic blood glucose levels The prognosis with surgery is acid reflux include chewing gum after a meal and eating a bit of licorice. foods to eat to prevent heartburn[ict-accordance.eu]
  • Stages of progression in prostate adenoma Stage One The best defense for prostatitis is prevention.[egipan.webcindario.com]

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