A Case of Pediatric Menetrier's Disease Associated with <i>Helicobacter pylori</i>  Infection

Yoon, Jihong; Ahn, Moon Bae; Maeng, Lee So; Kim, Sang Yong

doi:2014.14.4.288

Korean J Helicobacter Up Gastrointest Res > Volume 14(4); 2014 > Article

Case Report

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2014;14(4):288-291.
DOI: https://doi.org/10.7704/kjhugr.2014.14.4.288 Published online December 10, 2014.

A Case of Pediatric Menetrier's Disease Associated with Helicobacter pylori Infection

Jihong Yoon, Moon Bae Ahn, Lee So Maeng, Sang Yong Kim

¹Department of Pediatrics, The Catholic University of Korea, College of Medicine, Seoul, Korea. sykim2010@catholic.ac.kr
²Department of Hospital Pathology, The Catholic University of Korea, College of Medicine, Seoul, Korea.

Helicobacter pylori 감염과 연관된 소아 Menetrier 병 1예

윤지홍, 안문배, 맹이소¹, 김상용

가톨릭대학교 의과대학 소아과학교실, 병원병리학교실¹

Abstract

Menetrier's disease in childhood is a rare form of gastropathy characterized by hypoalbuminemia, endoscopic and/or radiologic findings of hypertrophic gastric folds, and histologic findings of foveolar hyperplasia in the stomach. It tends to have a self-limited course compared to the chronic and complicated course in adult Menetrier's disease. A 7-year-old boy was referred to Incheon St. Mary's Hospital for facial edema. Physical examination on admission showed periorbital swelling, pitting edema in both legs, and epigastric tenderness. Laboratory tests on admission indicated hypoproteinemia (3.0 g/dL) with hypoalbuminemia (2.1 g/dL) and hypogammaglobulinemia. Urinalysis showed no abnormalities. The test results for anti-cytomegalovirus immunoglobulin M and cytomegalovirus PCR were negative. Stool Helicobacter pylori antigen was positive and fecal alpha1-antitrypsin clearance was 40.1 mL/day, consistent with protein-losing gastroenteropathy. Gastroduodenoscopy showed hypertrophic edematous gastric folds, erythema, and superficial erosion in the body of the stomach. The duodenum was normal. Histologic findings showed foveolar hyperplasia. His symptoms improved with conservative treatment including proton pump inhibitor from day 9 of hospitalization and resolved completely. Here we reported a case of pediatric protein-losing hypertrophic gastropathy associated with Helicobacter pylori infection.

Key Words: Helicobacter pylori infection; Protein-losing gastropathy; Menetrier's disease