Ménétrier’s Disease and Ulcerative Colitis: True, True and Unrelated?
Bibliographic record
Abstract
Introduction: Ménétrier’s Disease (MD) is a rare hypertrophic gastropathy. Prior reports have suggested a relationship between ulcerative colitis (UC) and MD based on similar pathophysiologic mechanisms. In this study, we sought to quantify and describe our experience of patients with concurrent MD and UC. Methods: Patients with concurrent MD and UC diagnoses were identified from the electronic medical record using institutional software. Patients with both MD and UC ICD-9 codes documented between the dates of January 1, 1994 and May 15, 2014 were included for analysis. Records eligible for the software-based search were limited to those patients between the ages of 18 and 99 at the time of diagnosis. Results: From a database of over 7.4 million patients, 2 patients were identified with concomitant MD and UC. Both patients were male with a known history of mild UC (8 and 35-year durations) based on Montreal classification prior to MD diagnosis (established at ages 34 and 53, respectively). Neither had extra intestinal manifestations of UC; however, both had documented gastric polyposis preceding the diagnosis of MD. In each case, the patients presented with symptoms of episodic nausea, vomiting, and abdominal discomfort. Clinical presentations differed with lower extremity edema and weight loss being reported in opposite cases, while both had hypoalbuminemia. Endoscopic evaluation with endoscopic mucosal resection was performed and the diagnosis of MD was confirmed by histopathology in both cases. At MD diagnosis, each patient’s UC was in symptomatic remission while on differing UC maintenance regimens. In one case, 6-mercaptopurine and adalimumab were used, while the second patient was maintained on mesalamine monotherapy. Following both MD diagnoses, cetuximab infusion treatments were initiated resulting in symptomatic resolution. Both patients remain on cetuximab therapy and undergo annual endoscopic surveillance for gastric neoplasia. Conclusion: The rarity of concomitant MD and UC diagnoses suggests that these 2 diseases are likely independent pathophysiologic processes. The extremely low number of mutually affected patients does not allow for further co-variant assessment. While certain biologic pathways may be overlap between MD and UC, the rare association casts doubt on a shared pathogenesis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".