Cytomegalovirus-associated protein losing gastropathy in an immunocompetent adult : a case report

Cytomegalovirus infection of the gastro-intestinal tract is fre- quent and may be serious in the immunocompromised patient. We report a case of cytomegalovirus infection in an immunocompe- tent young man who presented total food intolerance, pleural effu- sion and oedema as the result of severe protein losing hypertrophic gastropathy. Hypertrophic gastropathy with severe mucosal pro- tein loss has been described in Menetrier's disease, a condition of unknown cause which involves foveolar hyperplasia of the gastric mucosa. Related hypoalbuminemia is responsible for a clinical pic- ture of diffuse edema. In adults, the natural course of the disease is marked by a chronic course and carries a bad prognosis. In our case, the disease ran a protracted disabling course, likely short- ened by ganciclovir therapy, followed by slow clinical, endoscopic and biochemical resolution after several months course. (Acta gastroenterol. belg., 2007, 70, 296-299).