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


  • • 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


  • • Total gastrectomy


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


  • • 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


  • • Hypoproteinemia


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


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]

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