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Case Reports in Gastrointestinal Medicine
Volume 2011, Article ID 480610, 5 pages
http://dx.doi.org/10.1155/2011/480610
Case Report

Atypical Clinical and Diagnostic Features in Ménétrier's Disease in a Child

1University of Kentucky College of Medicine, 138 Leader Avenue, Lexington, KY 40506-9983, USA
2University of Kentucky Children's Hospital, 800 Rose Street, Lexington, KY 40536-0298, USA
3Department of Pediatrics, Kentucky Clinic, J445 740 S. Limestone, Lexington, KY 40536-0284, USA
4Department of Internal Medicine, Kentucky Clinic, Room J525, 740 South Limestone, Lexington, KY 40536-0284, USA
5Department of Pathology, Medical Science Building, MS117, 800 Rose St., Lexington, KY 40536-0298, USA
6Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, University of Kentucky College of Medicine, 800 Rose Street, 109, Lexington, KY 40536-0298, USA

Received 13 June 2011; Accepted 7 July 2011

Academic Editors: K. Ina, S. Karoui, and M. Neri

Copyright © 2011 Michael Chung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ménétrier's disease is one of the rarest protein-losing gastropathies in childhood. It is characterized clinically by non-specific gastrointestinal symptoms and edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. In adults, this disease can be devastating with significant morbidity and mortality. In childhood, it is a self-limiting, transient and benign illness. Its treatment is largely supportive with total parenteral nutrition (TPN) while oral intake is encouraged. Acute onset of vomiting in healthy school age children can be initially explained by acute viral gastroenteritis. However, persistent vomiting associated with hematemesis and severe abdominal pain should warrant further work-up. This case report illustrates a self-limiting and rare cause of protein-losing enteropathy called Ménétrier's disease that presented with several variant clinical features not typically described in association with this entity.