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Pediatric hypertrophic gastropathy.

M P Marks, M V Lanza, E J Kahlstrom

    AJR. American Journal of Roentgenology
    |November 1, 1986
    PubMed
    Summary
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    Four children developed severe hypoproteinemia and stomach abnormalities. Cytomegalovirus (CMV) was detected in all cases, suggesting a potential link between this viral infection and the children's gastrointestinal symptoms.

    Area of Science:

    • Pediatric Gastroenterology
    • Infectious Diseases
    • Virology

    Background:

    • Hypoproteinemia in children can have various causes, including liver disease, malnutrition, and kidney issues.
    • Gastrointestinal manifestations of viral infections can be diverse and sometimes present atypically.

    Purpose of the Study:

    • To describe a series of four pediatric cases with unexplained hypoproteinemia and gastric abnormalities.
    • To investigate the potential role of cytomegalovirus (CMV) in the observed clinical presentation.

    Main Methods:

    • Case series review of four previously healthy children presenting within a 6-week period.
    • Clinical evaluation including assessment for liver disease, malnutrition, and proteinuria.
    • Radiographic imaging of the stomach.

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  • Laboratory investigations including viral cultures (CMV) from urine and gastric biopsies.
  • Histopathological examination of gastric biopsy specimens for viral inclusions.

    • Main Results:

    • All four children presented with marked hypoproteinemia, without evidence of liver disease, malnutrition, or significant proteinuria.
    • Strikingly similar radiographic findings showed enlarged gastric folds in the fundus and body.
    • Prodromal symptoms suggestive of viral illness were noted in three children.
    • Cytomegalovirus (CMV) was isolated from urine in all four patients and from gastric biopsies in three.
    • Gastric biopsy specimens from two patients revealed intranuclear inclusions consistent with CMV.

    Conclusions:

    • A cluster of pediatric cases with hypoproteinemia and characteristic gastric findings was observed.
    • Cytomegalovirus (CMV) was frequently detected in these patients, implicating it as a potential causative agent.
    • Further research is needed to definitively establish the causal relationship between CMV infection and this specific clinical syndrome in children.