Menetrier's disease presenting with ulcerative colitis: a case report and review of the literature

ABSTRACT

Menetrier's disease or hypertrophic gastritis is a premalignant rare disease that often presents with hypertrophy in the gastric folds, hypoalbuminemia and decreased acid secretion. There are a few papers worldwide that report concomitant Menetrier's disease and ulcerative colitis [U. C], however none are from Iran. This is the first case reported in Iranian literature. The pathogenesis of this coexistence is unknown. We report the case of a 28-year-old woman with intermittent bilateral edema of the lower extremities, weight loss and epigastric pain associated with chronic intermittent diarrhea and one episode of nocturnal dysentery. Paraclinical evaluations showed hypoalbuminemia, low serum protein level, severe 25 OH vitamin D deficiency, a positive Helicobacter pylori urea breath test and negative cytomegalovirus [CMV] IgM antibody. Histologic, radiologic and endoscopic findings were consistent with Menetrier's disease associated with U. C. The patient was prescribed mesalazine, asacol suppositories and pantoprazole. During a follow up visit the patient noted improvement in her symptoms. She was referred to a surgeon to discuss additional possible therapeutic treatments