Menetrier’s Disease

Menetrier’s disease

Q. 1

All are true regarding Menetrier’s disease, EXCEPT:

 A

Protein loss

 B

Exophytic growth

 C

Hypertrophy of gastric mucosa

 D

Premalignant condition

Q. 1

All are true regarding Menetrier’s disease, EXCEPT:

 A

Protein loss

 B

Exophytic growth

 C

Hypertrophy of gastric mucosa

 D

Premalignant condition

Ans. B

Explanation:

Answer is B (Exophytic growth)

Menetrier’s disease is characterized hr hypertrophy of gastric mucosa and not hr exoph;’tic growth.

Menetrier’s disease

Menetrier’s disease is a relatively rare disorder of the stomach characterized by lar e tortuous mucosal folds

Etiology

•   Etiology is unknown

•   Over expression of growth factors such as TGF are suggested

Pathology

Gross

•   Marked Hypertrophy of gastric folds/Rugaee

•   Hypertrophy results from hyperplasia of mucus producing cells (mucosa)Q

•   Hypertrophy is most prominent in the body and fundus °

Histological/microscopic

•   Massive foveolar hyperplasia (Hyperplasia of surface and glandular mucosal cells).

•   Pits of gastric glands elongate and may become tortuous

•   Lamina propria may contain a mild chronic inflammatory infiltrate

(Note: Although lamina propria may contain an inflammatory infiltrates, Menetrier’s disease is not considered a

form of gastritis

Clinical picture

•   Protein losing enteropathy is characteristic

Excessive protein is lost from the thickened mucosa into the gut which results in hypoprotenemia and edema

•   Gastric acid secretion is usually reduced or absent

This happens because mucosal cell hyperplasia replaces most of the parietal cells.

•   Epigastric pain accompanied by nausea, vomiting anorexia and weight loss

 

Overt bleeding is unusual but occult gastrointestinal bleeding may occur

Differential Diagnosis

DD includes conditions that may present with large gastric folds:

ZES

Malignancy

Infiltrative disorders eg sarcoidosis

Infectious etiology (CMV, Histoplasmosis, syphilis)

Prognosis

These is an increased risk of adenocarcinoma of stomach in adults with menetrier’s disease (CSDT)


Q. 2

All of the following statements about Menetrier’s  disease are true Except:

 A

It is a premalignant condition

 B

Usually increased acid secretion

 C

May be confused with Zollinger Ellison Syndrome

 D

Associated with Protein losing enteropathy

Q. 2

All of the following statements about Menetrier’s  disease are true Except:

 A

It is a premalignant condition

 B

Usually increased acid secretion

 C

May be confused with Zollinger Ellison Syndrome

 D

Associated with Protein losing enteropathy

Ans. B

Explanation:

Answer is B (Usually increased acid secretion)

Gastric acid secretion is usually reduced or absent because of replacement ofparictal cells’ Harrison’s

Menetrier’s disease carries an increased risk of developing adenocarcinoma of stomach (premalignant) is associated with a protein losing enteropathy and may be confused with Zollinger Ellison Syndrome as ZES also presents with large gastric folds.

Quiz In Between



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