Ménétrier's Disease: Causes, Symptoms, Diagnosis, Treatment
What Is Ménétrier's Disease?
Ménétrier’s Disease is a pathological condition in which there is enlargement of rugae, which are ridges present along the inside part of the wall of the stomach resulting in formation of large folds within the lining of the stomach. This enlargement of rugae takes place usually due to overgrowth of mucous cells in the wall of the stomach. Under normal circumstances, the mucous cells present in the rugae release mucus having proteins. In cases of enlarged rugae, the mucous cells produce excessive proteins which are then leaked from the bloodstream into the stomach causing the blood to become deficient of protein resulting in a condition hypoproteinemia. This disease also reduces acid-producing cells in the stomach resulting in decreased production of stomach acid.
What Are The Causes Of Ménétrier's Disease?
Researchers are still not quite sure about the exact cause of Ménétrier’s Disease, although they are of the opinion that this disease is an acquired one rather than an inherited one, although there have been extremely rare cases in which siblings have gone on to develop this condition suggesting that there may be a genetic link to Ménétrier’s Disease. Studies indicate that individuals with Ménétrier’s Disease have excessive amounts of protein called transforming growth factor-alpha, the overproduction of which causes Ménétrier’s Disease. Studies also indicate certain cases in which Ménétrier’s Disease was found in people who have had H. Pylori infection and treatment for H. Pylori have improved the symptoms caused by Ménétrier’s Disease. Researchers have also found certain cases in which cytomegalovirus has been linked with development of Ménétrier’s Disease, although they are still not quite certain as to how H. Pylori and CMV are linked to the development of Ménétrier’s Disease.
What Are The Symptoms Of Ménétrier's Disease?
Some of the symptoms of Ménétrier’s Disease are:
- Nausea and persistent vomiting
- Loss of appetite
- Severe weight loss
- Swelling of face, abdomen, and limbs
How Is Ménétrier's Disease Diagnosed?
The diagnosis of Ménétrier’s Disease is made by a combination of history and physical examination, lab testing, and upper GI endoscopy along with a biopsy of the stomach tissues. To begin with, the treating physician will take a detailed history and conduct a physical examination. The next step in confirming the diagnosis will be to conduct a CT scan which will easily show enlarged folds in the lining of the stomach thus confirming the disease along with doing an upper GI endoscopy. Tests may also be done to look for presence of H. Pylori or cytomegalovirus. A biopsy of the stomach tissue will also be taken and analyzed looking for any changes in the mucous cells of the stomach.
What Are Treatments For Ménétrier's Disease?
Treatment for Ménétrier’s Disease include medications, infusion of protein intravenously, blood transfusions, and even surgery.
Medications: The physician may prescribe anticancer medications like cetuximab for treatment of Ménétrier’s disease. Studies indicate that this medication is useful in reducing the thickness of the stomach wall and also improve the patient’s symptoms significantly. This medication is given intravenously, although studies to investigate the efficacy of this medication are still ongoing. Apart from this, the treating physician may also prescribe medications for control of nausea and abdominal pain due to Ménétrier’s Disease. In cases where Ménétrier’s Disease is caused due to H. Pylori or CMV, treating these above conditions go a long way in improving symptoms.
Intravenous infusion of Protein and Blood Transfusions: This treatment is done in individuals who become extremely malnourished or anemic due to Ménétrier’s Disease.
Surgery: In cases of severe Ménétrier’s Disease, surgery may be required to remove a part of all of the stomach. This procedure is called gastrectomy. Postprocedure, the surgeon will reconstruct the portion of the gastrointestinal tract. Usually, the surgeon will join the small intestine to the part of the stomach that is still left.