Difference between revisions of "Ménétrier's disease"

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#redirect [[Stomach#M.C3.A9n.C3.A9trier.27s_disease]]
'''Ménétrier's disease''' is a very rare pathology of the [[stomach]]. It is also known as '''diffuse foveolar cell hyperplasia'''.<ref name=Ref_PCPBoD8_410>{{Ref PCPBoD8|410}}</ref>


==General==
*Super rare.
*Increased risk of gastric adenocarcinoma.<ref name=Ref_PCPBoD8_410>{{Ref PCPBoD8|410}}</ref>
Clinical:<ref name=pmid20926644>{{Cite journal  | last1 = Rich | first1 = A. | last2 = Toro | first2 = TZ. | last3 = Tanksley | first3 = J. | last4 = Fiske | first4 = WH. | last5 = Lind | first5 = CD. | last6 = Ayers | first6 = GD. | last7 = Piessevaux | first7 = H. | last8 = Washington | first8 = MK. | last9 = Coffey | first9 = RJ. | title = Distinguishing Ménétrier's disease from its mimics. | journal = Gut | volume = 59 | issue = 12 | pages = 1617-24 | month = Dec | year = 2010 | doi = 10.1136/gut.2010.220061 | PMID = 20926644 }}</ref>
*Classical: nausea, emesis, abdominal pain and peripheral edema.
**Emesis (intractable) - '''most important'''.
Other:
*Gastric mass (may mimic cancer).
*Hypochlorhydria.
*Protein loss (hypoalbuminemia) - leads to peripheral edema.
Epidemiology:
*Men > women.
*Adults usually 50s.
*Associated with [[ulcerative colitis]].
Treatment:
*EGFR inhibitors.<ref name=pmid18321437>{{Cite journal  | last1 = Toubia | first1 = N. | last2 = Schubert | first2 = ML. | title = Menetrier's Disease. | journal = Curr Treat Options Gastroenterol | volume = 11 | issue = 2 | pages = 103-8 | month = Apr | year = 2008 | doi =  | PMID = 18321437 }}</ref>
*Gastrectomy.
==Gross==
*"Bag of worms" appearance - very thick gastric folds.
==Microscopic==
Features:<ref name=Ref_PCPBoD8_410>{{Ref PCPBoD8|410}}</ref>
*Foveolar cell hyperplasia - '''key feature'''.
*Decreased parietal cells.
*+/-Inflammation.
DDx:
*[[Cronkhite-Canada syndrome]].<ref name="pmid11428328">{{cite journal |author=Junnarkar SP, Sloan JM, Johnston BT, Laird JD, Irwin ST |title=Cronkhite-Canada syndrome |journal=The Ulster medical journal |volume=70 |issue=1 |pages=56–8 |year=2001 |month=May |pmid=11428328 |pmc=2449205 |doi= |url=}}</ref>
*[[Hyperplastic polyp of the stomach]].
Images:
*[http://path.upmc.edu/cases/case36.html Ménétrier's disease - crappy images (upmc.edu)].
==See also==
*[[Stomach]].
==References==
{{Reflist|2}}
[[Category:Stomach]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 11:24, 29 September 2013

Ménétrier's disease is a very rare pathology of the stomach. It is also known as diffuse foveolar cell hyperplasia.[1]

General

  • Super rare.
  • Increased risk of gastric adenocarcinoma.[1]

Clinical:[2]

  • Classical: nausea, emesis, abdominal pain and peripheral edema.
    • Emesis (intractable) - most important.

Other:

  • Gastric mass (may mimic cancer).
  • Hypochlorhydria.
  • Protein loss (hypoalbuminemia) - leads to peripheral edema.

Epidemiology:

Treatment:

  • EGFR inhibitors.[3]
  • Gastrectomy.

Gross

  • "Bag of worms" appearance - very thick gastric folds.

Microscopic

Features:[1]

  • Foveolar cell hyperplasia - key feature.
  • Decreased parietal cells.
  • +/-Inflammation.

DDx:

Images:

See also

References

  1. 1.0 1.1 1.2 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 410. ISBN 978-1416054542.
  2. Rich, A.; Toro, TZ.; Tanksley, J.; Fiske, WH.; Lind, CD.; Ayers, GD.; Piessevaux, H.; Washington, MK. et al. (Dec 2010). "Distinguishing Ménétrier's disease from its mimics.". Gut 59 (12): 1617-24. doi:10.1136/gut.2010.220061. PMID 20926644.
  3. Toubia, N.; Schubert, ML. (Apr 2008). "Menetrier's Disease.". Curr Treat Options Gastroenterol 11 (2): 103-8. PMID 18321437.
  4. Junnarkar SP, Sloan JM, Johnston BT, Laird JD, Irwin ST (May 2001). "Cronkhite-Canada syndrome". The Ulster medical journal 70 (1): 56–8. PMC 2449205. PMID 11428328. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2449205/.