Skip to Main Content

+

  • • Giant hypertrophy of the gastric rugae with excessive loss of protein from the thickened mucosa into the gut, with resulting hypoproteinemia

++

Epidemiology

+

  • • High, normal, or low acid secretion

    • Excessive loss of protein from the thickened mucosa into the gut, with resulting hypoproteinemia

    • In children, the disease characteristically is self-limited and benign

    • There is an increased risk of adenocarcinoma of the stomach in adults with Ménétrier disease

    • Associated with Helicobacter pylori infection

++

Symptoms and Signs

+

  • • Diarrhea

    • Indigestion

    • Anorexia

    • Weight loss

    • Skin rash

    • Edema from hypoproteinemia

    • Symptomatic anemia

++

Laboratory Findings

+

  • • Hypoproteinemia

    • Anemia

++

Imaging Findings

+

  • • The hypertrophic rugae present as enormous filling defects on upper GI contrast studies and are frequently misinterpreted as carcinoma

    • Hypertrophic rugae apparent on upper GI endoscopy

+

  • • Radiographic or endoscopic evidence of hypertrophic gastric rugae with hypoproteinemia is strongly suggestive of diagnosis

++

Rule Out

+

  • • Adenocarcinoma

+

  • • Upper GI contrast radiographic study

    • Upper GI endoscopy

    • Serum protein, Hct

+

  • • Goal is to reduce protein loss

++

Surgery

+

  • • Total gastrectomy

++

Indications

+

  • • Rarely indicated for severe intractable hypoproteinemia, anemia, or inability to exclude cancer

++

Medications

+

  • • Protein leak may respond to atropine, hexamethonium bromide, eradication of H pylori, H2 blocking agents, or omeprazole

++

Treatment Monitoring

+

  • • Endoscopic surveillance for development of adenocarcinoma

++

Complications

+

  • • Hypoproteinemia

++

Prognosis

+

  • • Despite medical management, gastric abnormalities and hypoproteinemia may persist

++

References

Madsen LG et al. Ménétrier's disease and Helicobacter pylori: normalization of gastrointestinal protein loss after eradication therapy. Dig Dis Sci. 1999;44:2307.  [PubMed: 10573379]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.