Stomach: Menetrier’s Disease

Menetrier’s Disease (Protein-Losing Hypertrophic Gastropathy)

Basics

  • Acquired Mucous Cell Hyperplasia & Loss of Parietal Cell Development
  • Features:
    • Giant Rugal Folds in Body & Fundus
    • Impaired Acid Secretion with Achlorhydria
    • Loss of Protein with Hypoalbuminemia
  • Associations:
    • Peds: CMV
    • Adults: H. pylori

Presentation

  • Abdominal Pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Anorexia

Diagnosis

  • Dx: Endoscopy & Bx

Treatment

  • Initial Tx: Supportive with High-Protein Diet
  • Adjuncts:
    • Ganciclovir or Triple/Quadruple Tx for Infection
    • PPI
    • Octreotide
  • Medical Therapy is Often Not Effective
  • If Fails & Severe: Total Gastrectomy

Giant Rugal Folds 1

Foveolar Cell Hyperplasia 1

References

  1. Bhattacharya K. Menetrier’s Disease with Gastrointestinal Bleed. J Minim Access Surg. 2005 Sep;1(3):136. (License: CC BY-2.0)