A case of Ménétrier's disease without Helicobacter pylori infection.
Ménétrier's disease (MD) is a rare, acquired, premalignant disorder of the stomach characterized by enlarged gastric folds with foveolar hyperplasia, the phenotype of antralization of gastric glands, hypochlorhydria and hypoproteinemia. The etiology of MD is unknown, but both increased signaling by transforming growth factor-α and infection with Helicobacter pylori (H. pylori) have been implicated. Here, a case involving 70-year-old man who lost weight after developing anorexia and diarrhea is reported. He was diagnosed as MD without H. pylori infection, and in spite of intensive care, he died 40 days after admission. An autopsy confirmed MD. Immunohistochemistry revealed overexpression of transforming growth factor-α in the foveolar region of the gastric mucosa. The autopsy also distinguished this H. pylori-negative MD from hyperplastic polyp of the stomach, which is important in clarifying the entity of H. pylori-negative MD.
Department of Gastroenterology, Sapporo Shirakaba-dai Hospital, Sapporo, Japan. t-endou@kouwakai.or.jp
Takao
T
Endo
Yoshiaki
Y
Arimura
Yasushi
Y
Adachi
Hiroaki
H
Mita
Kentaro
K
Yamashita
Hiroyuki
H
Yamamoto
Yasuhisa
Y
Shinomura
Yoshifumi
Y
Ishii
D000368:Aged; D051546:Cyclooxygenase 2 / Q000378:metabolism; D004108:Dilatation, Pathologic; D019160:Endosonography; D017809:Fatal Outcome; D005753:Gastric Mucosa / Q000378:metabolism* / Q000473:pathology; D005758:Gastritis, Hypertrophic / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D007150:Immunohistochemistry; D007327:Insufflation; D008297:Male; D015398:Signal Transduction / Q000502:physiology; D016211:Transforming Growth Factor alpha / Q000378:metabolism*
D016211:Transforming Growth Factor alpha; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human