Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy
Ménétrier’s disease (MD) is a rare gastropathy characterised by giant rugal folds which can present with nausea, vomiting, abdominal pain and protein losing gastropathy. We report a 21-year-old woman with comorbid MD and ulcerative colitis (UC). Management was complicated by limited treatment option...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-10-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/8/1/e000806.full |
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| author | Astrid-Jane Williams Weng Ng Carlos El-Haddad Watson Ng Amitabha Das Laura Willmann David Prince Tahrima Kayes Mark Bonnichsen Aldenb Lorenzo Zaid Househ Susan J Connor |
| author_facet | Astrid-Jane Williams Weng Ng Carlos El-Haddad Watson Ng Amitabha Das Laura Willmann David Prince Tahrima Kayes Mark Bonnichsen Aldenb Lorenzo Zaid Househ Susan J Connor |
| author_sort | Astrid-Jane Williams |
| collection | DOAJ |
| description | Ménétrier’s disease (MD) is a rare gastropathy characterised by giant rugal folds which can present with nausea, vomiting, abdominal pain and protein losing gastropathy. We report a 21-year-old woman with comorbid MD and ulcerative colitis (UC). Management was complicated by limited treatment options for MD, significant symptom burden, worsening nutrition and difficulty determining which disease was the predominant cause of symptoms. Since age 18 the patient experienced recurrent UC flares characterised by diarrhoea, persistent vomiting and corticosteroid dependence. Endoscopic assessment demonstrated concurrent MD and active UC. Octreotide and cetuximab were trialled given persistent hypoalbuminaemia and suspicion for MD associated protein-losing gastropathy. UC management comprised dose-optimised infliximab and methotrexate. Repeat endoscopic assessment demonstrated improvement in UC without corresponding improvement in symptoms or hypoalbuminaemia. Nasojejunal feeding and parenteral nutrition failed to significantly improve nutritional status and accordingly the patient proceeded to radical total gastrectomy. Postoperatively, MD-associated symptoms and hypoalbuminemia resolved completely. |
| format | Article |
| id | doaj-art-1814ca18f0204c30b6a210ef8b214f8d |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-1814ca18f0204c30b6a210ef8b214f8d2024-12-07T13:15:08ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742021-10-018110.1136/bmjgast-2021-000806Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomyAstrid-Jane Williams0Weng Ng1Carlos El-Haddad2Watson Ng3Amitabha Das4Laura Willmann5David Prince6Tahrima Kayes7Mark Bonnichsen8Aldenb Lorenzo9Zaid Househ10Susan J Connor11Ingham Institute, Liverpool, New South Wales, AustraliaDepartment of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, AustraliaDepartment of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, AustraliaDepartment of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, AustraliaDepartment of Upper GI surgery, Liverpool Hospital, Liverpool, New South Wales, AustraliaDepartment of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia2Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, AustraliaDepartment of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, AustraliaDepartment of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, AustraliaDepartment of Upper GI surgery, Liverpool Hospital, Liverpool, New South Wales, AustraliaDepartment of Anatomical Pathology, Liverpool Hospital, Sydney, New South Wales, AustraliaDepartment of Gastroenterology, Liverpool Hospital, Sydney, New South Wales, AustraliaMénétrier’s disease (MD) is a rare gastropathy characterised by giant rugal folds which can present with nausea, vomiting, abdominal pain and protein losing gastropathy. We report a 21-year-old woman with comorbid MD and ulcerative colitis (UC). Management was complicated by limited treatment options for MD, significant symptom burden, worsening nutrition and difficulty determining which disease was the predominant cause of symptoms. Since age 18 the patient experienced recurrent UC flares characterised by diarrhoea, persistent vomiting and corticosteroid dependence. Endoscopic assessment demonstrated concurrent MD and active UC. Octreotide and cetuximab were trialled given persistent hypoalbuminaemia and suspicion for MD associated protein-losing gastropathy. UC management comprised dose-optimised infliximab and methotrexate. Repeat endoscopic assessment demonstrated improvement in UC without corresponding improvement in symptoms or hypoalbuminaemia. Nasojejunal feeding and parenteral nutrition failed to significantly improve nutritional status and accordingly the patient proceeded to radical total gastrectomy. Postoperatively, MD-associated symptoms and hypoalbuminemia resolved completely.https://bmjopengastro.bmj.com/content/8/1/e000806.full |
| spellingShingle | Astrid-Jane Williams Weng Ng Carlos El-Haddad Watson Ng Amitabha Das Laura Willmann David Prince Tahrima Kayes Mark Bonnichsen Aldenb Lorenzo Zaid Househ Susan J Connor Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy BMJ Open Gastroenterology |
| title | Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy |
| title_full | Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy |
| title_fullStr | Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy |
| title_full_unstemmed | Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy |
| title_short | Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy |
| title_sort | menetrier s disease exacerbating ulcerative colitis and relieved by gastrectomy |
| url | https://bmjopengastro.bmj.com/content/8/1/e000806.full |
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