Editing Hypertrophic gastritis


Also known as Ménétrier disease and hypoproteinaemic hypertrophic gastropathy

== Epidemiology ==

* Rare

== Aetiology ==

* Unknown
* Seems to be associated with     CMV infection in children and H. pylori in adults

== Pathophysiology ==

* Histopathology will show     foveolar hyperplasia (expansion of surface mucus cells) with decreased or     absent parietal cells
* Associated with protein loss     from the stomach, excessive mucus production, and hypochlorhydria or     achlorhydria
* Increased levels of     transforming growth factor-alpha have been noted in the gastric mucosa of     patients with the disease, which can stimulate epithelial cell growth and     inhibit gastric acid secretion
* Associated with increased     risk of gastric neoplasm (risk estimates vary from 2-15%)

== Presentation ==

* Epigastric pain
* Vomiting
* Weight loss
* Decreased appetite
* Peripheral oedema

== Workup ==

* Gastroscopy
** Massive gastric folds in the      fundus and body of the stomach, giving the mucosa a cobblestone or      cerebriform appearance
** Antrum typically spared
** Biopsy the mucosa to      establish the diagnosis - need to exclude lymphoma and carcinoma

== Management ==

* Inconsistent results
* Acid suppression, octreotide,     and CMV/H. pylori eradication have been tried with some success
* Indications for total     gastrectomy:
** Patients who continue to      have massive protein loss despite optimal medical therapy and      high-protein diet
** Dysplasia/carcinoma

== Surveillance ==

* Gastroscopy every 1-2 years     to look for cancer

[[Category:UGIS]]