Successful symptomatic management of a patient with Ménétrier's disease with long-term antibiotic treatment.
We present the case of a 79-year-old female patient with criteria typical for Ménétrier's disease, i.e. enlargement of the gastric folds due to foveolar hyperplasia associated with severe protein-loss along with epigastric pain, nausea, vomiting and weight loss. Gastrin levels were within the normal range, but elevated Helicobacter pylori antibody titers (83 microg/ml) were indicative of a recent infection. Histologic examination of a gastric polyp, which was removed in toto, revealed the presence of early gastric cancer of the mucosal type. After initiation of antibiotic treatment with clarithromycin (3 x 250 mg/day) and metronidazole (2 x 500 mg/day) in combination with lansoprazole (30 mg/day), the patient's condition improved rapidly along with abrogation of protein loss. Under maintenance treatment as indicated above, the patient has been free of symptoms now for a period of more than 2 years. On repetitive endoscopic follow-up, there was no change in gastric mucosa morphology either endoscopically or histologically, and also no evidence of recurrence of a malignant lesion. We conclude that this therapeutic regimen represented an effective alternative to surgical intervention in this patient and should be considered in similar cases.
Raderer
M
M
Department of Internal Medicine I, University of Vienna, Austria.
Oberhuber
G
G
Templ
E
E
Wagner
L
L
Pötzi
R
R
Wrba
F
F
Hejna
M
M
Base
W
W
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005758:Gastritis, Hypertrophic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D064747:Lansoprazole; D008795:Metronidazole / Q000627:therapeutic use; D009853:Omeprazole / Q000031:analogs & derivatives / Q000627:therapeutic use
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D064747:Lansoprazole; D008795:Metronidazole; D017291:Clarithromycin; D009853:Omeprazole