A CASE OF MENETRIER'S DISEASE WITH SPECIFIC FINDINGS ON ULTRASONOGRAPHY AND CT SCAN

Abstract

We report a case of Menetrier's disease who has an onset in these six years and who showed a specific finding on ultrasonography and CT scan. This 66-year-old female patient was admitted to Iwakuni National Hospital because of meteorism and edema. An upper G. I. series performed six years ago revealed no abnormalities. She had neck lymphadenitis in 1935 and eosinophilia in 1979. The laboratory studies on admission showed a low serum total protein level (3.6g/dl). Protein loss into the G. I. tract was confirmed by the tests of ¹³¹I-RISA and ¹²⁵I-PVP. Gastric juice revealed hypoacidity and serum gastrin level was elevated. Huge, convoluted giant gastric rugae were demonstrated by upper G.I. series and endoscopic examination. The histology of the biopsied gastric mucosa disclosed hypertrophy of the mucosal epithelium and the lamina propria mucosae. On electron microscopic studies, a leak of body fluid from exfoliated mucosal epithelium was found, although the tight junction was normal. Giant rugae, projecting into the gastric lumen were detected by ultrasonography and CT scan. She was treated with oral cimetidine 800mg/day and the serum protein was elevated to 5.7g/dl, and she is still under this medical therapy.