Ménétrier's disease in a patient with refractory ulcerative colitis: a clinical challenge and review of the literature

Abstract

Ménétrier's disease (MD) is a rare disease of the stomach, characterised by hypertrophic gastric folds leading to protein loss. The association with ulcerative colitis (UC) is rare but has been reported in the literature. We report a case of a 29-year-old male affected by UC with an additional diagnosis of MD 3 years after UC diagnosis. UC was refractory to several treatment lines (thiopurines, infliximab, vedolizumab and ustekinumab), and the patient underwent colectomy. Octreotide was administered for MD normalising blood biochemistry, but it was not effective in inducing endoscopic remission of the stomach. Treatment options in patients with MD and UC are discussed.

Keywords: drugs: gastrointestinal system; gastroenterology; inflammatory bowel disease.

Figure 1

(A) Endoscopic appearance of the colon at the time of the first admission of the patient, showing mucosal lesions and the absence of vascular pattern; (B) histology of a biopsy specimen (H&E staining, original magnification 10×) with marked inflammatory infiltrate, crypt abscesses and superficial erosions.

Figure 2

(A) Endoscopic view of the stomach showing hypertrophic gastric folds, and (B) H&E staining showing cystic enlarged glands and mild inflammation (original magnification 20×).