[Ménétrier's disease--a rare cause of a protein deficiency syndrome]

Hypoproteinaemia (total proteins 5.2 g/dl) and hypoalbuminaemia (2.7 g/dl) were demonstrated in a 44-year-old woman with leg oedema during the previous four months and 10-kg weight gain during the previous year. A protein-losing enteropathy was diagnosed, all other causes having been excluded. Gastroscopy revealed giant hypertrophic gastritis. A biopsy showed foveolar hyperplasia with some inflammatory infiltrates, typical of Ménétrier's disease. Endosonography excluded any additional infiltrative process of the bowel wall. Long-term treatment with ranitidine, 150 g twice daily, achieved normalization of total protein and albumin concentrations. But the macroscopic changes in the gastric wall were still recognizable on repeat gastroscopy. As there is a danger of malignant degeneration gastroscopy and, if indicated, endosonography should be repeated annually.