Ménétrier Disease: Rare Manifestations and Mechanistic Insights From 2 Adult Cases

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.