Pediatr Gastroenterol Hepatol Nutr.  2013 Jun;16(2):123-126.

Co-Infection with Cytomegalovirus and Helicobacter pylori in a Child with Menetrier's Disease

• Yoo Y
• Lee Y
• Lee YM
• Choe YH

Abstract

Menetrier's disease is a rare protein-losing gastropathy characterized by hypertrophic gastric fold, foveolar hyperplasia, and hypoproteinemia with resulting peripheral edema. It is clinically evident as nonspecific gastrointestinal symptoms, including abdominal discomfort, nausea and vomiting, abdominal pain, weight loss, diarrhea, and edema. Pediatric Menetrier's disease usually has an insidious onset and progressive, chronic clinical course and it spontaneously resolves in weeks or months. The pathogenesis of Menetrier's disease is not clearly understood. Menetrier's disease is thought to be associated with some gastric infections. But the cause of Menetrier's disease is unknown, an association with cytomegalovirus (CMV) and Helicobacter pylori has been suggested. In Korea, We present the first a case of pediatric Menetrier's disease with positive evidence of CMV and H. pylori.

Keyword

Menetrier's disease; Cytomegalovirus; Helicobacter pylori

MeSH Terms

Abdominal Pain
Child
Coinfection
Cytomegalovirus
Diarrhea
Edema
Gastritis, Hypertrophic
Helicobacter
Helicobacter pylori
Humans
Hyperplasia
Hypoproteinemia
Korea
Nausea
Vomiting
Weight Loss

Figure

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  Fig. 1 Endoscopic findings of the present case. (A) Initial esophagogastroduodenoscopy shows enlarged erythematous gastric folds, and exudation in entire stomach. (B) Seven weeks after discharge, endoscopic findings were nearly normalized.

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  Fig. 2 A gastric biopsy shows the proliferation of the gastric glands (surrounded by arrows) and cystic dilatation without increase of granulocytes or eosinophils (immunostain, ×400).

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  Fig. 3 Cytomegalovirus (CMV) intranuclear inclusions (block dots indicated by arrows) were detected from gastric tissue using in-situ hybridization (H&E stain, ×400).

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