[A young man with acute, generalised oedema].
BACKGROUND
Ménétrier disease is an uncommon, idiopathic disease characterized by development of chronic protein loss from marked gastric foveolar hyperplasia. A literature search identified several reports of self-limiting, cytomegalovirus-associated Ménétrier disease in children. Some cases have also been reported in adults.


METHODS
A formerly healthy man was admitted to hospital with a serum albumin level of 11 g/l and generalised oedema. Transabdominal ultrasound and endoscopy revealed a folded thickening of the (abdominal) ventricular wall; indications of Ménétrier disease. Histological examination of endoscopic biopsies showed moderate hyperplasia in foveolar epithelium, but also suggested an infectious cause. Intranucleal inclusion bodies, CMV-specific immunology, PCR and special stains all supported cytomegalovirus infection. The patient recovered quickly on antiviral treatment.


CONCLUSIONS
Our case demonstrates that cytomegalovirus may cause severe, Ménétrier-like gastritis with protein loss in non-immune-compromised adults.
Engjom
Trond
T
Gastroseksjonen, Medisinsk avdeling, Haukeland universitetssykehus, 5021 Bergen, Norway. trond.engjom@helse-bergen.no
Larsen
Kristin Kampevold
KK
Hove
Oddbjørn
O
Gilja
Odd Helge
OH
D000328:Adult; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis*; D019160:Endosonography; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000188:drug therapy / Q000821:virology*; D005758:Gastritis, Hypertrophic / Q000175:diagnosis; D005773:Gastroscopy; D006801:Humans; D008297:Male; D011504:Protein-Losing Enteropathies / Q000175:diagnosis