Hypertrophic gastritis (Ménétrier disease)

Is an acquired rare premalignant disorder characterized by massive gastric folds involving the fundus and body.

On evaluation, the mucosa has a cobblestone appearance.

Histologic analysis reveals foveolar hyperplasia, and the absence of parietal cells.

Ménétrier disease is associated with protein loss from the stomach, excessive mucus production, and achlorhydria. It is linked with cytomegalovirus infection in children and H. pylori infection in adults.

Presenting symptoms are epigastric pain, weight loss, vomiting, and peripheral edema.

Medical treatment involves anticholinergics, acid suppression, octreotide, and H. pylori eradication.

Surgical treatment is via total gastrectomy, and is reserved for patients with massive protein loss despite adequate medical therapy, or for the development of dysplasia or carcinoma.