Ménétrier disease: A clinical review.

Abstract

Ménétrier disease (MD) is a rare gastric disorder characterized by hypertrophy of the gastric mucosa, resulting in giant gastric folds, excessive mucus secretion, and significant protein loss. It is most common in middle-aged males, although cases have also been reported in children. This condition, also known as hyperplastic hypersecretory gastropathy, primarily affects the fundus and body of the stomach, leading to protein-losing gastropathy due to increased mucosal permeability. The exact pathogenesis of MD remains unclear; however, it has been linked to excessive transforming growth factor-alpha signaling via the epidermal growth factor receptor (EGFR), which promotes mucosal hyperplasia. Clinical manifestations include epigastric pain, nausea, vomiting, anorexia, weight loss, and peripheral edema due to protein-losing enteropathy. Diagnosis is based on clinical presentation, endoscopic findings, and histopathology revealing foveolar hyperplasia and glandular atrophy. Treatment options vary from symptomatic management with proton pump inhibitors and nutritional support to monoclonal antibodies targeting EGFR (e.g., cetuximab) in severe cases. In refractory situations, gastrectomy may be required. This review highlights the current understanding, diagnostic approaches, and therapeutic strategies for MD.