Curriculum for Specialty Certificate Examination in Gastroenterology

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Monday, 21 April 2014

Ménétrier's disease

A rare disease that has a bimodal age distribution.  
The childhood form, more common in boys, is linked to CMV infection and o en resolves spontaneously, unlike the adult form.
The adult form, also more common in males, is thought to involve improper regulation of the epidermal growth factor receptor signaling pathway. 
Marked gastric mucosal hypertrophy secondary to hyperplasia of superficial mucosal epithelial cells leads to the characteristic large lobulated gastric folds. 
Giant rugal folds are most prominent along the greater curvature and tend to spare the antrum and cardia. 
Albumin loss across the gastric mucosa occurs at a high rate and is not only responsible for the clinical manifestation of peripheral edema, but also for intravascular hypovolemia which may account for the increased incidence of thrombotic events in the disease. 

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