Indexed on: 28 Jun '12Published on: 28 Jun '12Published in: BMJ case reports
Protein-losing gastropathy is a rare entity. Unlike the disease in adults, it usually is benign and self-limited in children. The aetiological contribution of cytomegalovirus has been insufficiently documented and the immunological status of patients was rarely described in most reports. The authors report an 11-year-old boy with generalised oedema and hypoproteinemia. Upper endoscopy with biopsies showed marked hypertrophy of gastric folds and foveolar hyperplasia involving the body and fundus. The presence of cytomegalovirus in gastric tissue was well documented through identification of intranuclear inclusions, immunohistochemistry and PCR. Immunodeficiency was clearly ruled out. Protein-losing gastropathy should be considered in children with oedema and hypoproteinemia. The aetiological diagnosis should be confirmed by endoscopy-based methods.