Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary 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] GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessSurgery 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessSurgery Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options