PROTEIN-LOSING GIANT FOLD GASTRITIS IN CH ILDHOOD - A CASE-REPORT ANDDIFFERENTIATION FROM MENETRIERS-DISEASE IN ADULTS

We report on a 2.5-year-old boy, who presented with vomiting since one week and periorbital and pitting edema. Laboratory studies revealed h ypoproteinemia and hypoalbuminemia without signs of renal or liver dis ease. The cause of protein loss was giant fold gastritis disclosed by upper endoscopy. Biopsies revealed foveolar hyperplasia with cystic di latation of the glands, identical to Menetrier's disease in adulthood. About 55 cases of hypertrophic gastropathy in children have been publ ished. In contrast to the chronic course of Menetrier's disease in adu lts. the pediatric cases are generally benign, self-limited with compl ete resolution typically within a few weeks. While the etiology of Men etrier's disease is still unknown, the benign pediatric hypertrophic g astropathies have been associated with infections, primarily CMV and o ccasionally helicobacter pylori, herpes simplex and mycoplasma. Suppor tive treatment with a high-protein-diet and intravenous albumin transf usions is recommended. H-2-receptor antagonists might improve symptoms .