DOI QR코드

DOI QR Code

Ménétrier's Disease as a Gastrointestinal Manifestation of Active Cytomegalovirus Infection in a 22-Month-Old Boy: A Case Report with a Review of the Literature of Korean Pediatric Cases

  • Hong, Jeana (Department of Pediatrics, Kangwon National University Hospital, Kangwon National University School of Medicine) ;
  • Lee, Seungkoo (Department of Anatomic pathology, Kangwon National University Hospital, Kangwon National University School of Medicine) ;
  • Shon, Yoonjung (Department of Anesthesiology, Kangwon National University Hospital, Kangwon National University School of Medicine)
  • Received : 2017.03.07
  • Accepted : 2017.05.08
  • Published : 2018.01.30

Abstract

$M{\acute{e}}n{\acute{e}}trier^{\prime}s$ disease (MD), which is characterized by hypertrophic gastric folds and foveolar cell hyperplasia, is the most common gastrointestinal (GI) cause of protein-losing enteropathy (PLE). The clinical course of MD in childhood differs from that in adults and has often been reported to be associated with cytomegalovirus (CMV) infection. We present a case of a previously healthy 22-month-old boy presenting with PLE, who was initially suspected to have an eosinophilic GI disorder. However, he was eventually confirmed, by detection of CMV DNA using polymerase chain reaction (PCR) with gastric tissue, to have MD associated with an active CMV infection. We suggest that endoscopic and pathological evaluation is necessary for the differential diagnosis of MD. In addition, CMV DNA detection using PCR analysis of biopsy tissue is recommended to confirm the etiologic agent of MD regardless of the patient's age or immune status.

Keywords

Acknowledgement

Supported by : Kangwon National University Hospital

References

  1. Vandenplas Y. Menetrier disease. In: Guandalini S, Dhawan A, Branski D, eds. Textbook of pediatric gastroenterology, hepatology and nutrition. Switzerland: Springer International Publishing; 2016. p. 157-158.
  2. Megged O, Schlesinger Y. Cytomegalovirus-associated protein-losing gastropathy in childhood. Eur J Pediatr 2008;167:1217-1220. https://doi.org/10.1007/s00431-008-0791-1
  3. Cieslak TJ, Mullett CT, Puntel RA, Latimer JS. Menetrier's disease associated with cytomegalovirus infection in children: report of two cases and review of the literature. Pediatr Infect Dis J 1993;12:340-343. https://doi.org/10.1097/00006454-199304000-00014
  4. Patra S, Samal SC, Chacko A, Mathan VI, Mathan MM. Cytomegalovirus infection of the human gastrointestinal tract. J Gastroenterol Hepatol 1999;14:973-976. https://doi.org/10.1046/j.1440-1746.1999.01986.x
  5. Ko HM, Morotti RA, Yershov O, Chehade M. Eosinophilic gastritis in children: clinicopathological correlation, disease course, and response to therapy. Am J Gastroenterol 2014;109:1277-1285. https://doi.org/10.1038/ajg.2014.166
  6. Dempsey PJ, Goldenring JR, Soroka CJ, et al. Possible role of transforming growth factor alpha in the pathogenesis of Menetrier's disease: supportive evidence form humans and transgenic mice. Gastroenterology 1992;103:1950-1963. https://doi.org/10.1016/0016-5085(92)91455-D
  7. Wang X, Huong SM, Chiu ML, Raab-Traub N, Huang ES. Epidermal growth factor receptor is a cellular receptor for human cytomegalovirus. Nature 2003;424:456-461. https://doi.org/10.1038/nature01818
  8. Sferra TJ, Pawel BR, Qualman SJ, Li BU. Menetrier disease of childhood: role of cytomegalovirus and transforming growth factor alpha. J Pediatr 1996;128:213-219. https://doi.org/10.1016/S0022-3476(96)70392-X
  9. Chetty R, Roskell DE. Cytomegalovirus infection in the gastrointestinal tract. J Clin Pathol 1994;47:968-972. https://doi.org/10.1136/jcp.47.11.968
  10. Umar SB, DiBaise JK. Protein-losing enteropathy: case illustrations and clinical review. Am J Gastroenterol 2010;105:43-49; quiz 50. https://doi.org/10.1038/ajg.2009.561
  11. Trout AT, Dillman JR, Neef HC, Rabah R, Gadepalli S, Geiger JD. Case 189: pediatric Menetrier disease. Radiology 2013;266:357-361. https://doi.org/10.1148/radiol.12111841
  12. Rich A, Toro TZ, Tanksley J, et al. Distinguishing Menetrier's disease from its mimics. Gut 2010;59:1617-1624. https://doi.org/10.1136/gut.2010.220061
  13. Takeyama J, Abukawa D, Miura K. Eosinophilic gastroenteritis with cytomegalovirus infection in an immunocompetent child. World J Gastroenterol 2007;13:4653-4654. https://doi.org/10.3748/wjg.v13.i34.4653
  14. Lim YJ, Rhee PL, Kim YH, et al. Clinical features of Menetrier's disease in Korea. Korean J Gastrointest Endosc 2000;21:909-916.
  15. Suter WR, Neuweiler J, Borovicka J, Binek J, Fantin AC, Meyenberger C. Cytomegalovirus-induced transient protein-losing hypertrophic gastropathy in an immunocompetent adult. Digestion 2000;62:276-279. https://doi.org/10.1159/000007827
  16. Cho JR, Kang SK, Kim YH, Choe YH. A case of Menetrier's disease associated with cytomegalovirus infection. Korean J Pediatr 2001;44:1197-1200.
  17. Choi WJ, Lee BY, Lee HJ, Oh HK, Hwang JB. Cytomegalovirus-induced childhood Menetrier's disease with peripheral eosinophilia. Korean J Pediatr Gastroenterol Nutr 2004;7:87-91.
  18. Son KH, Kwak JJ, Park JO. A case of cytomegalovirus-negative Menetrier's disease with eosinophilia in a child. Korean J Pediatr 2012;55:293-296. https://doi.org/10.3345/kjp.2012.55.8.293
  19. Yoo Y, Lee Y, Lee YM, Choe YH. Co-infection with cytomegalovirus and helicobacter pylori in a child with Menetrier's disease. Pediatr Gastroenterol Hepatol Nutr 2013;16:123-126. https://doi.org/10.5223/pghn.2013.16.2.123
  20. Yoon J, Ahn MB, Maeng L-S, Kim SY. A case of pediatric Menetrier's disease associated with helicobacter pylori infection. Korean J Helicobacter Up Gastrointest Res 2014;14:288-291. https://doi.org/10.7704/kjhugr.2014.14.4.288

Cited by

  1. Diagnosis and Management of Ménétrier Disease in Children: A Case Series Review vol.24, pp.1, 2018, https://doi.org/10.5223/pghn.2021.24.1.109
  2. Menetrier disease and Cytomegalovirus infection in paediatric age: report of three cases and a review of the literature vol.180, pp.3, 2021, https://doi.org/10.1007/s00431-020-03782-6
  3. Menetrier’s disease and differential diagnosis: A case report vol.9, pp.23, 2018, https://doi.org/10.12998/wjcc.v9.i23.6943