Internal Medicine

Ménétrier’s disease (MD)


Rare acquired disorder characterized by giant gastric rugal folds in the body and fundus, often with antral sparing, decreased acid secretion, increased gastric mucus production, and hypoalbuminemia secondary to protein loss in the gastric mucosa.

  • Also known as hyperplastic hypersecretory gastropathy or giant hypertrophic gastritis
  • Premalignant condition with an insidious onset with progressive features and is associated with an increased risk of gastric cancer.


Pierre Eugène Ménétrier (1859 – 1935) was a French pathologist from Paris. He is remembered for his description of a rare gastric disorder that was later to become known as Ménétrier’s disease.

In 1888 Ménétrier first described the disorder while performing post-mortem studies, noticing hyperplastic changes of the gastric mucosa in cadavers. At the time, he named the disease polyadenomes en nappe. Although Ménétrier understood the debilitative factors of the disease, it wouldn’t be until years later that the associated protein-losing enteropathic aspects of the disorder were realized. Other names for “Ménétrier’s disease” are “hyperplastic hypersecretory gastropathy” and “giant hypertrophic gastritis“. He published his findings in a treatise titled Des polyadenomes gastriques et de leurs rapports avec le cancer de l’estomac.


  • Gastric mucosal hyperplasia → Hypertrophied rugae → ↑ mucus production & resultant protein loss
  • Parietal cell atrophy → ↓ Acid production↑

Clinical presentation


  • Weight loss
  • Anorexia
  • Vomiting 
  • Epigastric pain
  • Peripheral oedema (due to hypoalbuminemia)



Endoscopic view of markedly thickened gastric folds, with overlying erosions and exudates involving fundus (A) and corpus (B). | Di Nardo, G., Oliva, S., Aloi, M., Ferrari, F., Frediani, S., Marcheggiano, A., & Cucchiara, S. (2012). A pediatric non-protein losing Menetrier’s disease successfully treated with octreotide long acting release. World Journal of Gastroenterology, 18(21), 2727–2729.


Differential diagnosis:

DiagnosisDistributionLocation in stomachHyperplastic mucosal compartmentPathologic features
Ménétrier’s diseaseDiffuseBody and fundus; relative sparing of antrumFoveolar epitheliumMassive foveolar hyperplasia
Hypertrophic lymphocytic gastritisDiffuseBody and fundus; relative sparing of antrumFoveolar epitheliumProminent intraepithelial lymphocytes
Hypertrophic hypersecretory gastropathyDiffuseBody and fundus; atrophic antrumAll layersHyperplasia of all glandular compartments
Zollinger-Ellison syndromeDiffuseBody and fundusParietal cellsParietal cell hyperplasia
Hyperplastic polypFocalAntrum; body and fundus also possibleFoveolar epitheliumFoveolar hyperplasia with architectural distortion
Polyposis syndrome with hamartomatous polypsVariableBody, fundus, and antrumFoveolar epitheliumFeatures similar to hyperplastic polyp
Gastric adenocarcinoma and proximal polyposis of the stomachVariableBody and fundusOxyntic glandsFundic gland polyps with low and high-grade dysplasia
Diffuse gastric carcinomaVariableBody, fundus, and antrumNot applicableInfiltrating carcinoma; diffuse type
LymphomaVariableBody, fundus, and antrumNot applicableEffacement of gastric mucosa by infiltrating lymphoma cells
AmyloidosisVariableBody, fundus, and antrumNot applicableAcellular, amorphous eosinophilic material surrounding glands and vessels


  • Cetuximab

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