Cytomegalovirus-Associated Menetrier Disease in Childhood

Menetrier disease (MD) is an uncommon disease that is characterized by gastric hypertrophy and hypoalbuminemia. The etiology of the disease is unknown but it is believed that transforming growth factor–α (TGF-α) plays a role in it. The clinical manifestations consist of edema, emesis, diarrhea, anorexia, abdominal pain, and vomiting. MD is generally associated with infections such as cytomegalovirus (CMV), herpes simplex virus, Helicobacter pylori, and Giardia. It has also been reported to be associated with allergy and some medications. Serum albumin decreases in affected patients due to protein loss through the gastric mucosa during the disease. Diagnosis of MD depends on endoscopic and/or radiologic findings. However, some studies have shown that the endoscopic and histopathologic features might be normal initially and they have suggested that serial biopsies should be considered. Most pediatric patients recover spontaneously within a few weeks and have good prognosis. In this report, we present 3 cases of MD associated with CMV infection with hypoalbuminemia and generalized edema.