Hong Jeana, Lee Seungkoo, Shon Yoonjung
Department of Pediatrics, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Department of Anatomic pathology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Clin Endosc. 2018 Jan;51(1):89-94. doi: 10.5946/ce.2017.038. Epub 2017 Jun 13.
Ménétrier's disease (MD), which is characterized by hypertrophic gastric folds and foveolar cell hyperplasia, is the most common gastrointestinal (GI) cause of protein-losing enteropathy (PLE). The clinical course of MD in childhood differs from that in adults and has often been reported to be associated with cytomegalovirus (CMV) infection. We present a case of a previously healthy 22-month-old boy presenting with PLE, who was initially suspected to have an eosinophilic GI disorder. However, he was eventually confirmed, by detection of CMV DNA using polymerase chain reaction (PCR) with gastric tissue, to have MD associated with an active CMV infection. We suggest that endoscopic and pathological evaluation is necessary for the differential diagnosis of MD. In addition, CMV DNA detection using PCR analysis of biopsy tissue is recommended to confirm the etiologic agent of MD regardless of the patient's age or immune status.
门脉高压性胃病(MD)以胃皱襞肥厚和小凹细胞增生为特征,是蛋白丢失性肠病(PLE)最常见的胃肠道病因。儿童MD的临床病程与成人不同,且常报道与巨细胞病毒(CMV)感染有关。我们报告一例先前健康的22个月大男孩,表现为PLE,最初怀疑患有嗜酸性胃肠道疾病。然而,最终通过对胃组织进行聚合酶链反应(PCR)检测CMV DNA,证实他患有与活动性CMV感染相关的MD。我们建议内镜和病理评估对于MD的鉴别诊断是必要的。此外,无论患者年龄或免疫状态如何,建议使用活检组织的PCR分析检测CMV DNA以确诊MD的病原体。