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Menetrier's disease (protein-losing gastropathy) in a child with acute lymphoblastic leukemia

Ashraf Fouda1,2, Binita Kamath3, Catherine Chung4

  • 1Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.

International Journal of Pediatrics & Adolescent Medicine
|July 16, 2019
PubMed

Insights

Menetrier

Area of Science:

  • Pediatric Gastroenterology
  • Onco-Gastroenterology

Background:

  • High-risk precursor-B acute lymphoblastic leukemia (ALL) treatment can involve complications.
  • Gastrointestinal symptoms in pediatric leukemia patients require thorough investigation.

Observation:

  • A 3-year-old boy with ALL presented with abdominal pain, vomiting, and hypoalbuminemia before high-dose methotrexate.
  • Imaging showed gastric and small bowel wall thickening; Cytomegalovirus (CMV) was detected but later negative.
  • Endoscopy revealed hypertrophic rugae and giant gastric folds, with biopsies negative for CMV.

Findings:

  • The patient was diagnosed with Menetrier's disease, a form of protein-losing gastropathy.
  • Supportive care and antiviral treatment led to clinical improvement.

Implications:

  • Menetrier's disease should be considered in pediatric leukemia patients with gastrointestinal symptoms and thickened stomach/bowel loops.
  • This case highlights the importance of considering rare gastrointestinal conditions in immunocompromised pediatric patients.
  • Early diagnosis and management of protein-losing gastropathy can improve outcomes in children with cancer.

Keywords:
Acute lymphoblastic leukemiaMenetrier's diseaseProtein-losing gastropathy

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