[Helicobacter pylori-associated hypertrophic gastritis. Imitation of Ménétrier disease]

A 42-year-old man developed giant fold gastritis that was associated with massive Helicobacter pylori colonization, highly active, high-grade gastritis and severe hypoproteinemia with gastric protein-loss syndrome. Histology revealed marked focal foveolar hyperplasia of the body and fundic mucosa. Combination treatment with amoxicillin and omeprazole resulted in the eradication of the Helicobacter pylori. Concomitantly, the foveolar hyperplasia, gastritis and the giant folds regressed completely, and the protein loss was arrested. It would appear highly likely that colonization with Helicobacter pylori had led to the formation of the giant folds and to gastric protein loss. The clinical picture described here mimics Ménétrier's disease, the cause of which is still unknown, and possibly represents a subgroup of this heterogeneous clinical entity.