Ménétrier Disease due to CMV Infection in 4 children

Introduction: Menetrier disease is a rare entity in children. It is characterized by hypertrophic gastritis and loss of protein causing hypoprotidemia. We report 4 cases diagnosed with CMV gastropathy, hospitalized in the pediatric department of SAHLOUL during a period of 10 years.

Results: Median age of patients was 34 months. The main symptoms were vomiting and abdominal pain. Physical examination general indicated edema and abdominal distension with mild diffuse tenderness and shifting dullness in one case. We noticed a quick evolution of this signs. Biologically, we report hypoalbuminemia between 12 g/l and 18g/l with negative urine protein. The clearance of alpha 1 antitrypsin was high in 3 cases. Fibroscopy revealed inflammatory and erosive large fold gastritis in four cases. The pathological examination showed active congestive gastritis with Helicobacter pylori in one case.CMV immunoglobulin M antibodies were detected in the serum in all cases. Their condition gradually improved with spontaneous resolution of symptoms within a period not exceeding three weeks.

Conclusion: Menetrier disease associated with CMV infection is a rare entity and can cause significant morbidity in all age groups: from neonates to adults. It should be considered in any patient with symptoms referable to the gastrointestinal tract and thickened stomach and bowel loops detected by radiologic imaging.