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Ménétrier Disease USMLE Notes & Mnemonics contains all the high-yield points you need to know.

  • Ménétrier Disease: Rare, acquired pre-malignant condition characterized by hypertrophic gastropathy with enlarged gastric folds. (Ref)


  • Marked hypertrophy of the gastric mucosa, especially the rugae of the stomach, leading to excessive mucous production and reduced acid production.
  • Protein-losing enteropathy due to increased permeability of the gastric mucosa.
  • Potential increase in risk of gastric adenocarcinoma.

Clinical Features

  • Abdominal pain
  • Weight loss
  • Edema due to hypoalbuminemia (protein-losing enteropathy)
  • Nausea and vomiting
  • Diarrhea
  • Anorexia
  • Gastrointestinal bleeding

Mnemonic: “MÉNÉTRIER’S

  • M = Massive gastric folds
  • É = Edema (due to hypoalbuminemia)
  • N = Nausea
  • É = Excess mucus production
  • T = Transformation risk (gastric carcinoma)
  • R = Rugae hypertrophy
  • I = Intrinsic factor decrease, leading to possible vitamin B12 deficiency
  • E = Eating problems (anorexia, weight loss)
  • R = Reduced acid production
  • S = Stomach pain


  • Endoscopy with biopsy: Crucial for diagnosis; giant gastric folds and foveolar hyperplasia.
  • Serum protein levels: Hypoalbuminemia.
  • Imaging: CT scan or gastric ultrasonography may show thickened gastric mucosa.
  • Stool alpha-1 antitrypsin clearance: To assess for protein-losing enteropathy.


  • Supportive treatment: Nutrition and management of hypoalbuminemia.
  • Medical treatment: Proton pump inhibitors; anticholinergic agents have been used but with variable success.
  • Octreotide: May help reduce protein loss.
  • Cytomegalovirus (CMV) treatment: If CMV is thought to be a contributing factor.
  • Surgery: Partial gastrectomy for severe disease not responsive to medical therapy, especially if there is significant bleeding or malignant transformation.


  • Chronic condition with variable course.
  • Increased risk for gastric carcinoma.
  • Surgical treatment may be curative, but relapses can occur.


  • Gastric cancer: Increased risk.
  • Anemia: Due to chronic protein loss and potential chronic blood loss.

Note: Ménétrier’s disease is a rare condition with an uncertain natural history, and evidence-based management is limited. Care should be taken to monitor for malignant transformation. Always consider current clinical guidelines and evidence when treating patients.

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