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Case Reports
. 2019 Mar;6(1):38-40.
doi: 10.1016/j.ijpam.2019.01.002. Epub 2019 Jan 7.

Menetrier's disease (protein-losing gastropathy) in a child with acute lymphoblastic leukemia

Ashraf Fouda  1   2 , Binita Kamath  3 , Catherine Chung  4 , Angela Punnett  1
Affiliations
Case Reports

Menetrier's disease (protein-losing gastropathy) in a child with acute lymphoblastic leukemia

Ashraf Fouda et al. Int J Pediatr Adolesc Med. 2019 Mar.

Erratum in

Abstract

A 3-year-old boy with high-risk precursor-B ALL presented with abdominal pain, vomiting, and hypoalbuminemia just before his second scheduled course of high-dose methotrexate in interim maintenance. Examination was significant for epigastric tenderness and periorbital edema. Abdominal imaging revealed a circumferential thickening of the stomach with an increased mucosal enhancement and a mild circumferential thickening of segments of small bowel loops. Cytomegalovirus (CMV) of the patient, determined by PCR, in blood was positive with a low titer and was subsequently negative. Upper endoscopy revealed hypertrophic rugae and folds in the stomach and duodenum, and biopsy showed giant gastric folds and foveolar hyperplasia but was negative for CMV. He received supportive care and a 2-week course of ganciclovir and Cytogam with clinical improvement. We report a case of Menetrier's disease (Protein-losing gastropathy), which was diagnosed in a child with acute leukemia. Menetrier's disease should be considered in any patient with symptoms referable to the gastrointestinal tract and thickened stomach and bowel loops detected by radiologic imaging.

Keywords: Acute lymphoblastic leukemia; Menetrier's disease; Protein-losing gastropathy.

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Figures

Fig. 1
Fig. 1
CT abdomen shows significant circumferential thickening of the stomach (complete arrow) and multiple short and long segments of small bowel loops with mild circumferential thickening and significantly increased enhancement (head arrows).
Fig. 2
Fig. 2
Upper gastrointestinal endoscopy shows hypertrophic rugae in the stomach.
Fig. 3
Fig. 3
Pathology of stomach biopsy H&E stain. A) Foveolar hyperplasia (magnification 10X) and B) glandular atrophy (magnification 20X).
See this image and copyright information in PMC

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