A Trivalent Gastropathy

Abstract

Current conceptions of Ménétrier's disease only obliquely resemble those originally described. Bona-fide cases are so uncommon that, of 125 cases diagnosed as Ménétier's disease, hypertrophic gastritis, or protein-losing gastropathy treated at the Massachusetts General Hospital during the 26-year period of 1962-1987, only six cases merited an unequivocal anatomic diagnosis. Two other cases previously described proved on review to be nondiagnostic in one instance and Campylobacter pylori gastritis in the other. Because abnormalities in the secretion of gastric acid and in the loss of protein from the stomach may coexist, a representation of each case in semiquantitative terms can be described on triaxial coordinates. Three patients had a hypercoagulable state, one in association with gastric carcinoma. One other case of gastric carcinoma and one of esophageal carcinoma coexistant with Ménétrier's disease were identified. Administration of subcutaneous heparin during the perioperative period to patients with Ménétrier's disease is appropriate regardless of whether or not hypercoagulation or carcinoma is manifest. If treatment with anticholinergic drugs and inhibitors of gastric acid secretion fails, total gastrectomy is the best solution, because it stops protein loss, eliminates hyperchlorhydria, prevents development of gastric carcinoma, and permits anastomotic reconstruction between normal esophagus and normal small bowel.

Hyperplastic and fibrosing gastropathy resembling Ménétrier disease in a cat

“…Ménétrier disease in humans is often accompanied by hypoalbuminaemia and hypochlorhydria, secondary to protein leakage across the gastric mucosa and reduced numbers of parietal cells, respectively. 2,23 Hypoalbuminaemia has also been reported in dogs with Ménétrier-like disease. 4,6,7 Mild hypoalbuminaemia and moderate hypoproteinaemia were present in the cat described here.…”

Total gastrectomy for the treatment of Menetrier’s disease persistent to medical therapy: A case report

“…Endoscopy reveals giant rugal edematous gastric folds symmetrically enlarged or seldom asymmetrically enlarged with polypoid appearance [ 6 ]. A full thickness biopsy is required to reveal the loss of the deep glandular component [ 7 ]. Histology shows diffuse foveolar hyperplasia with cystic dilatation of the glandular portion of the gastric mucosa and the absence of significant inflammatory infiltrate [ 8 ].…”