Giant Thickening of the Gastric Mucosa With Acid Hypersecretion and Protein-Losing Gastropathy

Summary A 46-year-old man had giant thickening of the gastric mucosa and hypoalbuminemia. In vivo labeling of plasma proteins with 51 CrCl 3 revealed gastrointestinal protein clearance about 36 times normal due to protein exudation from the stomach. He also had marked gastric hypersecretion of acid and pepsin in contrast to the hyposecretory state usually seen in Menetrier's disease. Chronic abdominal discomfort and recurrent gastrointestinal bleeding eventually required total gastrectomy. Histologically, the stomach showed a mixture of hyperplasia of oxyntic and zymogen cells with cystic degeneration in some areas.