Ménétrier disease is a rare disorder characterized by giant mucosal folds in the proximal stomach, reduced acid secretion, and protein-losing enteropathy with resulting hypoalbuminemia. The distal stomach is typically spared. Alternative terms include "hypoproteinemic hypertrophic gastropathy" and "giant hypertrophic gastritis." The condition predominantly affects men but also occurs in women and children. In adults, Ménétrier disease frequently follows a progressive course and is considered premalignant. The etiopathogenesis is incompletely understood.

Ménétrier disease (MD) is a rare gastric disorder characterized by hypertrophy of the gastric mucosa, resulting in giant gastric folds, excessive mucus secretion, and significant protein loss. It is most common in middle-aged males, although cases have also been reported in children. This condition, also known as hyperplastic hypersecretory gastropathy, primarily affects the fundus and body of the stomach, leading to protein-losing gastropathy due to increased mucosal permeability. The exact pathogenesis of MD remains unclear; however, it has been linked to excessive transforming growth factor-alpha signaling via the epidermal growth factor receptor (EGFR), which promotes mucosal hyperplasia. Clinical manifestations include epigastric pain, nausea, vomiting, anorexia, weight loss, and peripheral edema due to protein-losing enteropathy. Diagnosis is based on clinical presentation, endoscopic findings, and histopathology revealing foveolar hyperplasia and glandular atrophy. Treatment options vary from symptomatic management with proton pump inhibitors and nutritional support to monoclonal antibodies targeting EGFR (e.g., cetuximab) in severe cases. In refractory situations, gastrectomy may be required. This review highlights the current understanding, diagnostic approaches, and therapeutic strategies for MD.

BACKGROUND Menetrier disease is a rare gastric disorder characterized by hypertrophic hyperplastic changes in the stomach mucosa, hypoproteinemia, and symptoms like abdominal pain and diarrhea. It predominantly affects men aged 40-60 years and involves protein loss from the stomach. There have been few reports of cases complicated with severe anemia and secondary gastric outlet obstruction. The pathogenesis in adults remains unclear, although pediatric cases often are associated with cytomegalovirus (CMV) infection. CASE REPORT We present 2 adult cases. Case 1 was a 35-year-old man with a 2-month history of epigastric pain, vomiting, melena, and severe anemia. Lab tests revealed hypoproteinemia and low hemoglobin. Imaging and endoscopy showed gastric wall thickening, a gastric mass, and mucosal abnormalities. Histopathology confirmed Menetrier disease. Case 2 was a 44-year-old man with 6 years of epigastric fullness and belching. He had hypoproteinemia and multiple gastric nodules. Endoscopy revealed enlarged mucosal folds and polyps. Biopsies showed chronic inflammation and foveolar hyperplasia, consistent with Menetrier disease. CONCLUSIONS These cases highlight the diagnostic challenges of Menetrier disease, emphasizing the need for integrated clinical, endoscopic, and histopathological evaluation. Further studies are needed to explore the associations between Menetrier disease, Helicobacter pylori (H. pylori) infection, and gastric cancer.

Ménétrier disease (MD) is a rare condition characterized by hypertrophic gastropathy, leading to enlarged gastric folds, excessive mucus production, and protein loss. Among the approximately 150 cases of reported pediatric MD, the usual presenting features are peripheral oedema, anasarca, and gastrointestinal symptoms. This case report describes a 2-year-old child presenting with gastric outlet obstruction, an unusual manifestation of MD, which has not been described previously in the pediatric age group.

We present the case of a 71-year-old male with difficult to manage severe chronic diarrhea, who after multiple tests was finally diagnosed with Ménétrier's disease and had clinical improvement with treatment with intramuscular octreotide. A high degree of clinical suspicion is essential to diagnose this entity, exclude similar entities and the correlation of clinical, analytical, endoscopic, radiological and histological data.