Menetrier's disease is a form of hyperplastic gastropathy with increased loss of proteins into gastric secretions.


Etiology: unknown


Some cases are hereditary with a family history of the condition.


Clinical findings:

(1) Typically affects middle aged males.

(2) epigastric pain

(3) bloating

(4) anorexia

(5) weight loss

(6) vomiting

(7) diarrhea

(8) peripheral and pulmonary edema secondary to hypoproteinemia

(9) thrombotic events (similar to the hypercoagulable state seen with the protein loss in the nephrotic syndrome)

(10) recurrent infections

(11) upper GI bleeding may occur


Laboratory findings:

(1) hypoproteinemia and hypoalbuminemia secondary to chronic protein loss

(2) elevated protein in gastric fluid

(3) eosinophilia

(4) hypochlorhydria (reflecting atrophy of glandular epithelium)


Pathologic findings:

(1) hyperplastic gastropathy affecting the body and greater curvature of the stomach

(2) hyperplastic gastropathy does not involve the antrum

(3) biopsy shows foveolar hyperplasia with atrophy of the gastric glands and with cystic dilatation


Differential diagnosis:

(1) other forms of hyperplastic gastropathy

(2) hypertrophic lymphocytic gastritis


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