Hypoproteinemic hypertrophic gastropathy

Also known as Menetrier disease, this is a premalignant disorder of the stomach characterized by overgrowth of the stomach lining (gastric mucosa), nausea and vomiting and abdominal pain, and hypoalbuminemia (low blood serum level of albumin) due to loss of albumin by the stomach. The abnormalities of the stomach in Menetrier's disease are highly characteristic with giant folds, excess mucus secretion by the lining of the stomach, and hypochlorhydria (decreased acid secretion by the stomach). The disease tends to lead to stomach cancer. Symptoms include nausea, vomiting, pain in the abdomen, swelling, poor appetite, and weight loss. The cause of Menetrier's disease is not known, although infections with cytomegalovirus and Helicobacter pylori have been suspected to play a role. The overgrowth of the stomach lining (gastric hypertrophy) in Menetrier's disease appears to be due to activation of the receptor for epidermal growth factor in the stomach. Treatment of severe disease can involve partial or complete removal of the stomach. Treatment with a monoclonal antibody against the epidermal growth factor receptor has been reported to result in marked reduction in the frequency of nausea and vomiting, an increase in the serum albumin concentration, and improvement in the abnormalities of the stomach. (New England Journal of Medicine 343:1697, 2000) History and nomenclature: The disease was first described in 1888 by P. Menetrier. His name has an acute accent on the first two e's and is pronounced may-nay-tree-yeh. Menetrier disease is also called hypoproteinemic hypertrophic gastropathy.